Provider Demographics
NPI:1578001509
Name:STOLARSKI, KELSEY (DC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:STOLARSKI
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 1:740 E WASHINGTON ST STE E4
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2136
Mailing Address - Country:US
Mailing Address - Phone:330-591-5663
Mailing Address - Fax:
Practice Address - Street 1:740 E WASHINGTON ST STE E4
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2136
Practice Address - Country:US
Practice Address - Phone:330-591-5663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor