Provider Demographics
NPI:1174250302
Name:KALMAN, SPENCER (PT, DPT)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:KALMAN
Suffix:
Gender:M
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 1:1814 HIGHPOINT AVE APT 1142
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4313
Mailing Address - Country:US
Mailing Address - Phone:703-907-9282
Mailing Address - Fax:
Practice Address - Street 1:100 GATEWAY CENTRE PKWY # 205A
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5174
Practice Address - Country:US
Practice Address - Phone:804-377-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist