| Micheal J Klitzke | |
|
6025 Brookvale Ln Suite 205 Knoxville TN 37919-4031 | |
| (865) 588-6916 | |
| Not Available |
| Full Name | Micheal J Klitzke |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 6025 Brookvale Ln, Knoxville, Tennessee |
| Authorized Official Name and Position | Michael John Klitzke (PRESIDENT/OWNER) |
| Authorized Official Contact | 8655886916 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Micheal J Klitzke 6025 Brookvale Ln Suite 205 Knoxville TN 37919-4031 Ph: (865) 588-6916 | Micheal J Klitzke 6025 Brookvale Ln Suite 205 Knoxville TN 37919-4031 Ph: (865) 588-6916 |
| NPI Number | 1831363126 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 04/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831363126 | NPI | - | NPPES |
| 3688001 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 1761 (Tennessee) | Primary |
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