Individual
KENNETH KALLIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
9540 DILEEN ST, SAN ANTONIO, TX 78263-9625
(210) 643-6760
Mailing address
9540 DILEEN ST., SAN ANTONIO, TX 78263
(210) 643-6760
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
572418
TX
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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