Healthcare Provider Details

I. General information

NPI: 1578957809
Provider Name (Legal Business Name): LACYGNE CHIROPRACTIC CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 COMMERCIAL ST
LA CYGNE KS
66040-6097
US

IV. Provider business mailing address

PO BOX 195
LA CYGNE KS
66040-0195
US

V. Phone/Fax

Practice location:
  • Phone: 913-757-2003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-05528
License Number StateKS

VIII. Authorized Official

Name: DR. CHELSIE STAINBROOK
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 913-909-8965