Provider Demographics
NPI:1588035760
Name:BUTH, KELSIE M (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:KELSIE
Middle Name:M
Last Name:BUTH
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 SAINT ROSE PKWY UNIT 1012
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8935 S PECOS RD STE 21B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7155
Practice Address - Country:US
Practice Address - Phone:702-367-3600
Practice Address - Fax:702-947-2636
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor