Healthcare Provider Details

I. General information

NPI: 1295038453
Provider Name (Legal Business Name): KATHLEEN ALBERT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10074 WOODLAND RD
LENEXA KS
66220
US

IV. Provider business mailing address

5431 WOODSTOCK ST
SHAWNEE KS
66218-9277
US

V. Phone/Fax

Practice location:
  • Phone: 913-393-2222
  • Fax:
Mailing address:
  • Phone: 210-284-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-05356
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2013008841
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: