Provider Demographics
NPI:1104257047
Name:EDWARDS, KALI (DC)
Entity type:Individual
Prefix:DR
First Name:KALI
Middle Name:
Last Name:EDWARDS
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 1:1122 S WESTNEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1350
Mailing Address - Country:US
Mailing Address - Phone:269-383-4325
Mailing Address - Fax:844-272-9281
Practice Address - Street 1:46980 48TH AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MI
Practice Address - Zip Code:49064
Practice Address - Country:US
Practice Address - Phone:269-383-4325
Practice Address - Fax:844-272-9281
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2522797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor