Provider Demographics
NPI:1033203450
Name:KALIS, ARRON R (DC)
Entity Type:Individual
Prefix:
First Name:ARRON
Middle Name:R
Last Name:KALIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-2014
Mailing Address - Country:US
Mailing Address - Phone:507-526-2211
Mailing Address - Fax:507-526-3003
Practice Address - Street 1:220 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUE EARTH
Practice Address - State:MN
Practice Address - Zip Code:56013-2014
Practice Address - Country:US
Practice Address - Phone:507-526-2211
Practice Address - Fax:507-526-3003
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN497428000Medicaid
IA0737536Medicaid
MN317S3KAOtherBCBS
MN350003418Medicare ID - Type Unspecified
MNV05666Medicare UPIN