Healthcare Provider Details

I. General information

NPI: 1922993773
Provider Name (Legal Business Name): SEBASTIAN KALM DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 RUSH WAY STE 103
O FALLON MO
63368-2328
US

IV. Provider business mailing address

10 ARDENNES PL
LAKE ST LOUIS MO
63367-1634
US

V. Phone/Fax

Practice location:
  • Phone: 816-433-8420
  • Fax:
Mailing address:
  • Phone: 636-515-8261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2025018488
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: