Klak, Carol
Klak, Carol is an individual health care provider with primary practice located at 1142 Orlando Dr , De Pere WI 54115-9484. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Klak, Carol can be contacted via phone (920) 339-0700.Contact Information
Primary practice address
1142 Orlando Dr
De Pere WI 54115-9484
Phone: (920) 339-0700
Fax: (920) 330-0278
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 1491-026 | Wisconsin |
Profile Details
| NPI number | 1164548731 |
|---|---|
| LBN Legal business name | Klak, Carol |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164548731 | NPPES |
| Wisconsin | MEDICAID | 40567000 |
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