Individual
JEFFREY LEONARD KALLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
843 W ANNANDALE WAY, ORO VALLEY, AZ 85737-6923
(952) 412-6207
(952) 412-6207
Mailing address
843 W ANNANDALE WAY, ORO VALLEY, AZ 85737-6923
(952) 412-6207
(952) 412-6207
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10878PT
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160D2KA
BLUECROSS BLUESHIELD OF MINNESOTA
MN
05
—
600088600
—
MN
Enumeration date
10/03/2006
Last updated
02/20/2017
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