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General NPI Number Information
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NPI Number | 1336029289
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Entity Type | Individual
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Provider Name | KEENAN KALTENBACHER
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Gender | Male
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1331 N ELM ST STE 200
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City | GREENSBORO
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State | NC
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Zip | 27401-6304
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Country | US
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Telephone | 336-274-6682
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Fax |
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Provider Business Mailing Address
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Address Line | 5240 SAMET DR APT 2D
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City | HIGH POINT
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State | NC
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Zip | 27265-3537
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Country | US
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Telephone | 719-367-3440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NC
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