Individual provider · NPI-1
Jacob Kloser
Technician, Attendant Care Provider · Peoria, AZ
NPI number1386256642
StatusActive
Last updated in NPPESAug 18, 2020
Details
- NPI
- 1386256642
- Entity type
- Individual (NPI-1)
- Name
- Jacob Kloser
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 18, 2020
- Certification date
- Aug 18, 2020
- Last updated
- Aug 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | AZ | Yes |
Practice location
21738 N 91st LnPeoria, AZ 85382-8345
Phone 602-882-7601
Mailing address
21738 N 91st LnPeoria, AZ 85382-8345
Phone 602-882-7601
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