Provider Demographics
NPI:1063087179
Name:KLINGEMAN, ADAM WILLIAM (DPT)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:WILLIAM
Last Name:KLINGEMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 STANTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1952
Mailing Address - Country:US
Mailing Address - Phone:502-938-5056
Mailing Address - Fax:
Practice Address - Street 1:2525 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2665
Practice Address - Country:US
Practice Address - Phone:502-459-6307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist