Provider Demographics
NPI:1184993545
Name:KLUEVER, JENNIFER L (MOT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:KLUEVER
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:SUITE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4190
Mailing Address - Country:US
Mailing Address - Phone:563-355-9200
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:2451 CORAL CT
Practice Address - Street 2:SUITE 1
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2837
Practice Address - Country:US
Practice Address - Phone:319-853-0596
Practice Address - Fax:319-853-0983
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002172225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist