Individual
JOHN E KLECZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
430 MANOR DR, SURING, WI 54174-9182
(920) 842-2191
(920) 842-2176
Mailing address
N4575 STATE HIGHWAY 32, KRAKOW, WI 54137-9087
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3227-26
WI
225X00000X
Occupational Therapist
3227026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40894800
—
WI
Enumeration date
05/24/2007
Last updated
07/12/2024
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