Healthcare Provider Details

I. General information

NPI: 1962347799
Provider Name (Legal Business Name): KATIE ELIZABETH CALHOON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3422 S GLENSTONE AVE
SPRINGFIELD MO
65804-4412
US

IV. Provider business mailing address

304 W PICARDY ST
REPUBLIC MO
65738-7867
US

V. Phone/Fax

Practice location:
  • Phone: 417-216-6079
  • Fax:
Mailing address:
  • Phone: 229-223-6016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2025047182
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: