Provider Demographics
NPI:1548812639
Name:KLINGMANN, JENNIFER LYNN (LMT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:KLINGMANN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:PURKHISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:374 US HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:EASTPOINT
Mailing Address - State:FL
Mailing Address - Zip Code:32328-3400
Mailing Address - Country:US
Mailing Address - Phone:954-290-6564
Mailing Address - Fax:
Practice Address - Street 1:374 US HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:EASTPOINT
Practice Address - State:FL
Practice Address - Zip Code:32328-3400
Practice Address - Country:US
Practice Address - Phone:954-290-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA88284225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist