Individual
MARK KLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12 HARVEST, IRVINE, CA 92604-3234
(949) 677-5029
(949) 654-8715
Mailing address
12 HARVEST, IRVINE, CA 92604-3234
(949) 677-5029
(949) 654-8715
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
18176
CA
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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