Provider Demographics
NPI:1154780302
Name:KLENDA, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:KLENDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6724 RED BARN DR
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-0209
Mailing Address - Country:US
Mailing Address - Phone:785-577-6389
Mailing Address - Fax:
Practice Address - Street 1:5711 N INTERSTATE 27
Practice Address - Street 2:UNIT 3
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79403-7524
Practice Address - Country:US
Practice Address - Phone:785-577-6389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer