MEDICARE: KARA JEAN KALBUS D.C.

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
1	111N00000X	Chiropractor	4765	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063582187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARA JEAN KALBUS D.C.

Provider Business Mailing Address
First Line	:	8017 MAGNOLIA LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-7177
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 WAYZATA BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2145
Country	:	US
Telephone Number	:	612-554-1354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	09/27/2010

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