Doctor Name: | DR. JON MARK KAKLEAS |
NPI Number: | 1184841728 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C., P.T. |
License Number: | DC 23537 |
Business Practice Address: | 4380 Redwood Hwy Ste B6 San Rafael, CA - 949032110 |
Business Phone Number: | 4154998469 |
Business Fax Number: | 4154998645 |
Mailing Address: | 4380 Redwood Highway, Ste. B-6, SAN RAFAEL |
State: | CA |
Postal Code: | 94903 |
Phone Number: | 4154998469 |
Fax Number: | 4154998645 |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC 23537 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |