Individual
KEVIN KALISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
110 BEECH ST, SUITE B, TAWAS CITY, MI 48763-8314
(989) 362-1015
(989) 362-9862
Mailing address
110 BEECH ST STE B, TAWAS CITY, MI 48763-8314
(989) 362-9859
(989) 362-9862
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003895
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3370220
—
MI
Enumeration date
10/06/2005
Last updated
04/06/2021
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