MEDICARE: KELSEY STALLBAUMER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2015022046	MO
2	111N00000X	Chiropractor	01-05738	KS

General Provider Information

NPI Number	:	1376926212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY STALLBAUMER D.C.

Provider Business Mailing Address
First Line	:	206 S 1ST ST
Second Line	:
City	:	HIAWATHA
State	:	KS
Zip	:	66434-2618
Country	:	US
Telephone Number	:	785-742-7164
Fax Number	:	816-436-7501

Provider Business Practice Location Address
First Line	:	206 S 1ST ST
Second Line	:
City	:	HIAWATHA
State	:	KS
Zip	:	66434-2618
Country	:	US
Telephone Number	:	785-742-7164
Fax Number	:	816-436-7501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2015
Last Update Date	:	10/16/2024

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Directions to “ KELSEY STALLBAUMER D.C.” Practice Location

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