MEDICARE: DR. KYLE TIMOTHY KOLLBAUM 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	4077-012	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	412011981012	OTHER	WI	BLUE CROSS BLUE SHIELD
3	49D87KO	OTHER	MN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1992701056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE TIMOTHY KOLLBAUM D.C.

Provider Business Mailing Address
First Line	:	W4083 490TH AVE
Second Line	:
City	:	ELLSWORTH
State	:	WI
Zip	:	54011-5823
Country	:	US
Telephone Number	:	715-273-5901
Fax Number	:	715-273-3427

Provider Business Practice Location Address
First Line	:	430 N MAPLE ST
Second Line	:	STE 200
City	:	ELLSWORTH
State	:	WI
Zip	:	54011-9029
Country	:	US
Telephone Number	:	715-273-3175
Fax Number	:	715-273-3427

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	01/22/2013

Similar Medicare Providers

1659572048 — KOLLBAUM CHIROPRACTIC LIMITED
Practice Location Address:

430 N MAPLE ST , SUITE 200
ELLSWORTH, WI
54011-9029

Practice Phone: 715-273-3175
Practice Fax: 715-273-3427

1275464729 — KATELYN ASMUS OTR/L
Practice Location Address:

445 S PIETY ST
ELLSWORTH, WI
54011-9117

Practice Phone: 715-273-3900
Practice Fax: 715-273-5775

1699606301 — JESSICA PUHRMANN
Practice Location Address:

445 S PIETY ST # 1500
ELLSWORTH, WI
54011-9117

Practice Phone: 715-273-3911
Practice Fax:

1952231490 — KJRSTEN LOKKER
Practice Location Address:

445 S PIETY ST
ELLSWORTH, WI
54011-9117

Practice Phone: 715-273-3912
Practice Fax:

1881713964 — CHRISTINA TREU
Practice Location Address:

445 S PIETY ST
ELLSWORTH, WI
54011-9117

Practice Phone: 715-273-3908
Practice Fax:

1609827997 — ELLSWORTH AREA AMBULANCE SERVICE INC
Practice Location Address:

151 S PLUM ST
ELLSWORTH, WI
54011-4137

Practice Phone: 715-273-4879
Practice Fax:

Directions to “ DR. KYLE TIMOTHY KOLLBAUM D.C.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.