Healthcare Provider Details

I. General information

NPI: 1588222616
Provider Name (Legal Business Name): KENZIE JEAN KALWAY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W 70TH ST
RICHFIELD MN
55423-7555
US

IV. Provider business mailing address

1820 XENIUM LN N
PLYMOUTH MN
55441-3708
US

V. Phone/Fax

Practice location:
  • Phone: 612-798-6000
  • Fax:
Mailing address:
  • Phone: 763-559-3535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: