Healthcare Provider Details

I. General information

NPI: 1568324192
Provider Name (Legal Business Name): KC INTEGRATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E JOPPA RD STE 300
TOWSON MD
21286-3108
US

IV. Provider business mailing address

200 E JOPPA RD STE 300
TOWSON MD
21286-3108
US

V. Phone/Fax

Practice location:
  • Phone: 410-296-7700
  • Fax:
Mailing address:
  • Phone: 410-296-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: WARREN KALKSTEIN
Title or Position: CEO & OWNER
Credential: DC
Phone: 443-465-9023