MS. Theresa D Klose

NPI #1467447946 in Mafb, Alabama

Provider Information

NPI Number: 1467447946
Entity Type: Individual
Name: MS. Theresa D Klose
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dietitian, Registered
Enumeration Date: Sep 12, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 700 TWINING STREET
City: Mafb
State: Alabama
ZIP Code: 36112
Phone: (334) 953-5143

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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