MEDICARE: KALAMAR PHYSICAL THERAPY LLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1851931414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALAMAR PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	2241 WILLOW OAK CIR APT 202
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6840
Country	:	US
Telephone Number	:	484-241-1519
Fax Number	:

Provider Business Practice Location Address
First Line	:	5252 LEARNING CIR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1399
Country	:	US
Telephone Number	:	484-241-1519
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAYLEIGH MARIE KALAMAR
Credential	:	PT, DPT, CSCS
Telephone Number	:	484-241-1519

Provider Enumeration Date	:	01/13/2020
Last Update Date	:	01/13/2020

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