| Organization Name: | KLEINEBREIL OPTOMETRY PLLC |
| NPI Number: | 1255778270 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANNA LEAH TANKE-KLEINEBREIL (PRESIDENT) |
| Mailing Address: | 927 S Otsego Ave Gaylord |
| State: | MI US |
| Postal Code: | 497351783 |
| Phone Number: | 9897327518 |
| Fax Number: | 9897324205 |
| NPI Enumeration Date: | 05/30/2013 |
| NPI Last Update Date: | 10/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 4901004610 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |