Provider Demographics
NPI:1114915550
Name:KALTVED, CHAD R (DC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:R
Last Name:KALTVED
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 1:1111 MORNINGVIEW DR
Mailing Address - Street 2:PO BOX 469
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537-2000
Mailing Address - Country:US
Mailing Address - Phone:712-755-5878
Mailing Address - Fax:712-755-5463
Practice Address - Street 1:1111 MORNINGVIEW DR
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-2000
Practice Address - Country:US
Practice Address - Phone:712-755-5878
Practice Address - Fax:712-755-5463
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06318111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1242107Medicaid
IAI15424Medicare PIN
IA1242107Medicaid