Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | S01373 | MD |
NPI | 1063580785 |
---|---|
Provider Name | Jeffrey William Kalkstein |
First Address | Towson, MD 21204-5027 |
Second Address | Towson, MD 21204-5027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 05/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T59569 | (02) | MD |