Provider Demographics
NPI:1104141068
Name:KALP-LAXTON, KATHY A (DC)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:A
Last Name:KALP-LAXTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:JONES MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15646-1112
Mailing Address - Country:US
Mailing Address - Phone:724-433-9910
Mailing Address - Fax:724-372-7911
Practice Address - Street 1:3824 NORTHERN PIKE
Practice Address - Street 2:SUITE 1015
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2141
Practice Address - Country:US
Practice Address - Phone:412-372-7900
Practice Address - Fax:412-732-7911
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003141L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAKA481666Medicare PIN