Healthcare Provider Details

I. General information

NPI: 1114915550
Provider Name (Legal Business Name): CHAD R KALTVED DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MORNINGVIEW DR
HARLAN IA
51537-2000
US

IV. Provider business mailing address

1111 MORNINGVIEW DR PO BOX 469
HARLAN IA
51537-2000
US

V. Phone/Fax

Practice location:
  • Phone: 712-755-5878
  • Fax: 712-755-5463
Mailing address:
  • Phone: 712-755-5878
  • Fax: 712-755-5463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06318
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: