Provider Demographics
NPI:1295038453
Name:ALBERT, KATHLEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5431 WOODSTOCK ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9277
Mailing Address - Country:US
Mailing Address - Phone:210-284-8801
Mailing Address - Fax:
Practice Address - Street 1:10074 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66220
Practice Address - Country:US
Practice Address - Phone:913-393-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05356111N00000X
MO2013008841111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor