Provider Demographics
NPI:1760075725
Name:RADABAUGH, KATHERINE MEALER (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MEALER
Last Name:RADABAUGH
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 1:1365 AMSTEL DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4084
Mailing Address - Country:US
Mailing Address - Phone:901-275-0723
Mailing Address - Fax:
Practice Address - Street 1:1365 AMSTEL DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4084
Practice Address - Country:US
Practice Address - Phone:901-275-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherI AM NOT WITH ANY PROVIDERS. I AM A CASH BASED PRACTICE.