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Contact Information

THERESA D KLOSE
700 TWINING STREET
MAXWELL AFB, AL36112
 Phone: 334-953-5143
 Fax: 334-953-8296
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for THERESA D KLOSE · (Female)

NPI Number 1467447946
Status Active
Credentials
Entity Individual
Enumeration date 09/12/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • AL License # 1494
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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