Provider Demographics
NPI:1306032776
Name:KALISH, HOWARD R (DC)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:R
Last Name:KALISH
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 1:3624 E DAHLIA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7338
Mailing Address - Country:US
Mailing Address - Phone:314-495-6608
Mailing Address - Fax:
Practice Address - Street 1:5410 N SCOTTSDALE RD
Practice Address - Street 2:SUITE D-100
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-5927
Practice Address - Country:US
Practice Address - Phone:480-941-2147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor