Doctor Name: | MR. KALEB SHANE BIRNEY |
NPI Number: | 1144629593 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC, LAT, CSS |
License Number: | AT-LAT-LIC-1102 |
Business Practice Address: | 710 S Atlantic St Dillon, MT - 597253511 |
Business Phone Number: | 4066837329 |
Business Fax Number: | |
Mailing Address: | 15 Aurora Lane, DILLON |
State: | MT |
Postal Code: | 597257354 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/21/2014 |
NPI Last Update Date: | 08/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | AT-LAT-LIC-1102 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |