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NPI Code Detail

MEDICARE: DR. CLINT RICHARD KALBACH DPT

MEDICARE:  DR. CLINT RICHARD KALBACH  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician2305205933VA
2225100000XPhysical Therapist2305205933VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12305205933OTHERVAVIRGINIA STATE PHYSICAL THERAPY LICENSE

General Provider Information

NPI Number : 1013142652
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLINT RICHARD KALBACH DPT
Provider Business Mailing Address
First Line : PO BOX 490
Second Line :
City : MONTEREY
State : VA
Zip : 24465-0490
Country : US
Telephone Number : 540-247-1751
Fax Number :
Provider Business Practice Location Address
First Line : 120 JACKSON RIVER RD
Second Line :
City : MONTEREY
State : VA
Zip : 24465-2416
Country : US
Telephone Number : 540-468-6400
Fax Number : 540-468-3301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2009
Last Update Date : 03/31/2022

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Directions to “ DR. CLINT RICHARD KALBACH DPT” Practice Location

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