Provider Demographics
NPI:1902178072
Name:KLOK, ANNE LEA (RCEP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:LEA
Last Name:KLOK
Suffix:
Gender:F
Credentials:RCEP
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Mailing Address - Street 1:5174 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-9627
Mailing Address - Country:US
Mailing Address - Phone:269-372-1823
Mailing Address - Fax:269-552-2201
Practice Address - Street 1:3025 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1281
Practice Address - Country:US
Practice Address - Phone:269-552-2215
Practice Address - Fax:269-552-2201
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist