Provider Demographics
NPI:1811276066
Name:KALISH, TONI THERESE (PT)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:THERESE
Last Name:KALISH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4 WINGSPAN CT
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1834
Mailing Address - Country:US
Mailing Address - Phone:636-578-5514
Mailing Address - Fax:636-265-2158
Practice Address - Street 1:643 KNOLLSHIRE WAY
Practice Address - Street 2:
Practice Address - City:DARDENNE PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63368-8379
Practice Address - Country:US
Practice Address - Phone:636-578-5514
Practice Address - Fax:636-265-2158
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO109323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist