Diane Marie Klika, PT
Individual provider Active NPI Physical Therapist · Berlin, WI
NPI 1043483860 · NPPES record last updated Apr 13, 2008
Key facts
- NPI
- 1043483860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4054-024 (WI)
- Practice address
- 225 Memorial Dr
Berlin, WI 54923-1243 - Phone
- (920) 361-5534
- Fax
- (920) 361-5190
- NPI assigned
- Apr 13, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4054-024 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4054-024 | WI | Yes |
Addresses
Primary practice location
225 Memorial Dr
Berlin, WI 54923-1243
Mailing address
464 River Dr
Berlin, WI 54923-1133
Phone (920) 229-1179
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40181000 | Medicaid | WI |
Other providers in Berlin, WI
- Melissa A Johnston
- David R Jones
- Dale E Kanak
- Philip A Keith
- Kristin Klassa
- Benjamin John Kozloski
- Keith Anthony Krause
- Stephanie Krause
- Danielle Lynn Krueger
- Lakeside Neurocare Limited
All providers in Berlin, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.