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Individual

LEANNE M KLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1409 ASHEVILLE HWY, BREVARD, NC 28712-9524
(828) 435-8400
(828) 435-8401
Mailing address
200 SAINT CLAIR AVE, JTDM FAMILY PRACTICE LLC, SAINT MARYS, OH 45885-2400
(419) 394-3387
(419) 394-9580

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2020-00325
NC
207Q00000X
Family Medicine Physician
35.123708
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0105065
GROUP MEDICAID
OH
05
0106492
OH
01
1184652539
GROUP NPI
OH
01
2020-00325
NC LICENSE
NC
01
9934723
MEDICARE GROUP PTAN
OH
Enumeration date
06/20/2011
Last updated
03/01/2021
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