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MICHEAL J KLITZKE

Clinical Neuropsychologist

Knoxville, Tennessee

Provider NPI: 1831363126

Organization Information:
Organization Name:  MICHEAL J KLITZKE
Organization is not Subpart
Authorized Official:  MICHAEL JOHN KLITZKE  PRESIDENT/OWNER  865-5886916

Practice Location:
6025 BROOKVALE LN SUITE 205 KNOXVILLE, TN 37919 US
Tel: 865-588-6916  Fax: --

Business Mailing Address:
6025 BROOKVALE LN SUITE 205 KNOXVILLE, TN 37919 US
Tel: 865-588-6916  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
TN1761

Other Provider Identifiers:

IssuerNumberStateType
3688001TN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS TN - Page 1

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