Provider Demographics
NPI:1033515564
Name:KALKSTEIN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KALKSTEIN CHIROPRACTIC LLC
Other - Org Name:ADOLPH AND KALKSTEIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KALKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-296-7700
Mailing Address - Street 1:200 E JOPPA RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-3150
Mailing Address - Country:US
Mailing Address - Phone:410-296-7700
Mailing Address - Fax:
Practice Address - Street 1:200 E JOPPA RD
Practice Address - Street 2:SUITE 300
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-3150
Practice Address - Country:US
Practice Address - Phone:410-296-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
M393OtherMEDICARE PTAN
350021754OtherRAILROAD MEDICARE PTAN
W020OtherBLUE CROSS