Provider Demographics
NPI:1639275134
Name:KALLIO, ROBERT ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALEXANDER
Last Name:KALLIO
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 1:1600 S 70TH ST
Mailing Address - Street 2:SUTIE 201
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1568
Mailing Address - Country:US
Mailing Address - Phone:402-484-5166
Mailing Address - Fax:402-484-5177
Practice Address - Street 1:1600 S 70TH ST
Practice Address - Street 2:SUTIE 201
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1568
Practice Address - Country:US
Practice Address - Phone:402-484-5166
Practice Address - Fax:402-484-5177
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5751111N00000X
NE1256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE27278OtherBCBS OF NEBRASKA
COU79467Medicare UPIN
NEP01053013Medicare PIN