Provider Demographics
NPI:1023223286
Name:KALAROVICH, MARK EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:KALAROVICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EAST JEFFERSON ST
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:WHEATLAND
Mailing Address - State:IA
Mailing Address - Zip Code:52777-0070
Mailing Address - Country:US
Mailing Address - Phone:563-374-1535
Mailing Address - Fax:563-374-1145
Practice Address - Street 1:110 EAST JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHEATLAND
Practice Address - State:IA
Practice Address - Zip Code:52777-0070
Practice Address - Country:US
Practice Address - Phone:563-374-1535
Practice Address - Fax:563-374-1145
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0193052Medicaid
IA047773Medicare Oscar/Certification
IAU73549Medicare UPIN