Healthcare Provider Details

I. General information

NPI: 1306708946
Provider Name (Legal Business Name): WILLIAM SEAN KELLENBERGER RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 US 6 W
IOWA CITY IA
52246
US

IV. Provider business mailing address

910 N 4TH AVE
WASHINGTON IA
52353-2506
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-0581
  • Fax:
Mailing address:
  • Phone: 319-677-2474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number002959
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: