Provider Demographics
NPI:1700532934
Name:KALISH, DANIEL J (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:KALISH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 MAYS BLVD STE 10507
Mailing Address - Street 2:
Mailing Address - City:INCLINE VILLAGE
Mailing Address - State:NV
Mailing Address - Zip Code:89451-7633
Mailing Address - Country:US
Mailing Address - Phone:800-616-7708
Mailing Address - Fax:
Practice Address - Street 1:692 PALMER COURT
Practice Address - Street 2:UNIT 4
Practice Address - City:INCLINE VILLAGE
Practice Address - State:NV
Practice Address - Zip Code:89451
Practice Address - Country:US
Practice Address - Phone:800-616-7708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor