Individual
JEREMY M KALTENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
613 23RD ST STE G30, ASHLAND, KY 41101-2881
(606) 327-0036
(606) 327-0036
Mailing address
2828 1ST AVE, SUITE 400, HUNTINGTON, WV 25702-1236
(304) 525-6905
(304) 525-4316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
943
WV
363AM0700X
Medical Physician Assistant
00943
WV
363AM0700X
Medical Physician Assistant
50.001490
OH
363AM0700X
Medical Physician Assistant
Primary
PA1816
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100191670
—
KY
Enumeration date
04/27/2006
Last updated
04/19/2018
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