Most Relevant Information
Provider Data
| NPI Number: | 1003063603 |
| Provider Name: | KELAINE KVALE CERTPS |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/26/2008 |
| Last Updated: | 08/26/2008 |
Provider Practice Location
1545 W MOCKINGBIRD LN
SUITE 3005
DALLAS
TX
752355014
Practice Location Phone/Fax
| Phone: | 2148199911 |
| Fax: | 2148199944 |
Provider Mailing Location
1545 W MOCKINGBIRD LN
SUITE 3005
DALLAS
TX
752355014
Provider Mailing Phone/Fax
| Phone: | 2148199911 |
| Fax: | 2148199944 |