1730124553 NPI number — MR. JOHN MORGAN KALTENBORN MS, ATC, PES

Table of content: MR. JOHN MORGAN KALTENBORN MS, ATC, PES (NPI 1730124553)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730124553 NPI number — MR. JOHN MORGAN KALTENBORN MS, ATC, PES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KALTENBORN
Provider First Name:
JOHN
Provider Middle Name:
MORGAN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS, ATC, PES
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730124553
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
JAMES MADISON UNIVERSITY
Provider Second Line Business Mailing Address:
MSC 2301 GODWIN HALL RM. 128
Provider Business Mailing Address City Name:
HARRISONBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22807-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-568-8020
Provider Business Mailing Address Fax Number:
540-568-6950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
JAMES MADISON UNIVERSITY
Provider Second Line Business Practice Location Address:
MSC 2301 GODWIN HALL RM. 128
Provider Business Practice Location Address City Name:
HARRISONBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22807-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-568-8020
Provider Business Practice Location Address Fax Number:
540-568-6950
Provider Enumeration Date:
06/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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