Provider Demographics
NPI:1699015545
Name:STAINBROOK, CHELSIE (DC)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:
Last Name:STAINBROOK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CHELSIE
Other - Middle Name:
Other - Last Name:KETTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 195
Mailing Address - Street 2:
Mailing Address - City:LA CYGNE
Mailing Address - State:KS
Mailing Address - Zip Code:66040-0195
Mailing Address - Country:US
Mailing Address - Phone:913-757-2003
Mailing Address - Fax:913-757-2003
Practice Address - Street 1:210 NORTH COMMERCIAL STREET
Practice Address - Street 2:
Practice Address - City:LA CYGNE
Practice Address - State:KS
Practice Address - Zip Code:66040
Practice Address - Country:US
Practice Address - Phone:913-757-2003
Practice Address - Fax:913-757-2003
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor