Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CP003862 | SC |
NPI | 1275807174 |
---|---|
Provider Name | Brian Kaluf |
First Address | Exton, PA 19341-2514 |
Second Address | Greenville, SC 29615-6301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2012 |
Last Update Date | 23/05/2013 |