Provider Demographics
NPI:1124209333
Name:MERSBERG, KERRY LOUISE (DC CPED)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:LOUISE
Last Name:MERSBERG
Suffix:
Gender:F
Credentials:DC CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-5906
Mailing Address - Country:US
Mailing Address - Phone:620-251-4848
Mailing Address - Fax:620-251-4848
Practice Address - Street 1:107 W 12TH ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-5906
Practice Address - Country:US
Practice Address - Phone:620-251-4848
Practice Address - Fax:620-251-4848
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor