Healthcare Provider Details

I. General information

NPI: 1528078953
Provider Name (Legal Business Name): ROLAND F KAELIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 PITMAN AVE
PITMAN NJ
08071-1657
US

IV. Provider business mailing address

376 PITMAN AVE
PITMAN NJ
08071-1657
US

V. Phone/Fax

Practice location:
  • Phone: 856-582-2442
  • Fax: 856-589-7955
Mailing address:
  • Phone: 856-582-2442
  • Fax: 856-589-7955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00185500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: