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EILEEN R KALK PA

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1538268016

Individual Registrant:
 EILEEN R KALK PA
Gender: F
Sole Proprietor

Location and contact information for practice:
4135 MAIN ST  KELSEYVILLE, CA 95451-8941 US
Tel: 707-279-1888  Fax: --

Contact information for business:
975 PAGE DR  LAKEPORT, CA 95453-3419 US
Tel: 707-263-1855  Fax: --

Registration Information:
NPI: 1538268016
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CAPT10212
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CA17682

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PA LICENSE NUMBER17682CA01




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