Provider Demographics
NPI:1801882840
Name:KALAROVICH, PATRICIA M H (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M H
Last Name:KALAROVICH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:110 EAST JEFFERSON STREET
Mailing Address - City:WHEATLAND
Mailing Address - State:IA
Mailing Address - Zip Code:52777-0070
Mailing Address - Country:US
Mailing Address - Phone:563-374-1535
Mailing Address - Fax:563-974-1145
Practice Address - Street 1:110 EAST JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:WHEATLAND
Practice Address - State:IA
Practice Address - Zip Code:52777-0070
Practice Address - Country:US
Practice Address - Phone:563-374-1535
Practice Address - Fax:563-374-1145
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009648225100000X
IA02116225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0193078Medicaid
IA01817Medicare UPIN