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General NPI Number Information
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NPI Number | 1376926212
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Entity Type | Individual
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Provider Name | KELSEY STALLBAUMER D.C.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 206 S 1ST ST
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City | HIAWATHA
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State | KS
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Zip | 66434-2618
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Country | US
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Telephone | 785-742-7164
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Fax | 816-436-7501
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Provider Business Mailing Address
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Address Line | 206 S 1ST ST
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City | HIAWATHA
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State | KS
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Zip | 66434-2618
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Country | US
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Telephone | 785-742-7164
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Fax | 816-436-7501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2015022046
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01-05738
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License Number State | KS
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