Provider Demographics
NPI:1336506336
Name:SLAUBAUGH, KALAIS M (DPT)
Entity Type:Individual
Prefix:
First Name:KALAIS
Middle Name:M
Last Name:SLAUBAUGH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KALAIS
Other - Middle Name:
Other - Last Name:KUHLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:850 43RD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-8401
Mailing Address - Country:US
Mailing Address - Phone:309-743-2070
Mailing Address - Fax:309-743-2073
Practice Address - Street 1:419 W BRIDGE RD
Practice Address - Street 2:STE A
Practice Address - City:POLK CITY
Practice Address - State:IA
Practice Address - Zip Code:50226-2219
Practice Address - Country:US
Practice Address - Phone:515-984-6377
Practice Address - Fax:515-984-6782
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080282225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist