Provider Demographics
NPI:1487001269
Name:STALLBAUMER FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:STALLBAUMER FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLBAUMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-294-0884
Mailing Address - Street 1:206 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2618
Mailing Address - Country:US
Mailing Address - Phone:785-742-7164
Mailing Address - Fax:
Practice Address - Street 1:206 S 1ST ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2618
Practice Address - Country:US
Practice Address - Phone:785-742-7164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05788111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty