Provider Demographics
NPI:1730843327
Name:KALBACH, ANNIE LYN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:LYN
Last Name:KALBACH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 WILBERT AVE
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1441
Mailing Address - Country:US
Mailing Address - Phone:908-616-6621
Mailing Address - Fax:
Practice Address - Street 1:333 ATLANTIC CITY BLVD UNIT B18
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1262
Practice Address - Country:US
Practice Address - Phone:732-269-1938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA018126002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic