MEDICARE: KELSEE WADE DC

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	14664	TX

General Provider Information

NPI Number	:	1427887488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEE WADE DC

Provider Business Mailing Address
First Line	:	PO BOX 950
Second Line	:
City	:	PALESTINE
State	:	TX
Zip	:	75802-0950
Country	:	US
Telephone Number	:	903-729-3772
Fax Number	:	903-723-0920

Provider Business Practice Location Address
First Line	:	2114 STATE HIGHWAY 155
Second Line	:
City	:	PALESTINE
State	:	TX
Zip	:	75803-8606
Country	:	US
Telephone Number	:	903-729-3772
Fax Number	:	903-723-0920

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

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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Directions to “ KELSEE WADE DC” Practice Location

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