Individual
KEITH KALLENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 AKRON GENERAL AVE, AKRON, OH 44307-2432
(330) 344-6000
Mailing address
224 W EXCHANGE ST, STE 220, AKRON, OH 44302-1704
(330) 344-6401
(330) 344-1714
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
21-195978
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000023799
ANTHEM PIN
OH
05
—
0770438
—
OH
01
—
430003430
TRAVELERS PIN
OH
Enumeration date
06/21/2005
Last updated
11/17/2017
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