Provider Demographics
NPI:1508505439
Name:SEABOLT, ALEXIS KAYLEE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:KAYLEE
Last Name:SEABOLT
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 1:22568 SW 600TH RD
Mailing Address - Street 2:
Mailing Address - City:WELDA
Mailing Address - State:KS
Mailing Address - Zip Code:66091-9100
Mailing Address - Country:US
Mailing Address - Phone:620-631-0275
Mailing Address - Fax:620-531-0272
Practice Address - Street 1:208 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3226
Practice Address - Country:US
Practice Address - Phone:620-531-0275
Practice Address - Fax:620-531-0272
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0106194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor