Provider Demographics
NPI:1528403417
Name:DOBESH, KELSEY JO (DC)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:JO
Last Name:DOBESH
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 1:1415 WEST HAVEN AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-8301
Mailing Address - Country:US
Mailing Address - Phone:605-996-1160
Mailing Address - Fax:605-996-6433
Practice Address - Street 1:1415 W HAVENS AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4102
Practice Address - Country:US
Practice Address - Phone:605-996-1160
Practice Address - Fax:605-996-6433
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor