Provider Demographics
NPI:1205301306
Name:PITMAN, KATELYN (DC)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:
Last Name:PITMAN
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 1:13458 110TH ST
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:KS
Mailing Address - Zip Code:66066-5213
Mailing Address - Country:US
Mailing Address - Phone:816-718-9660
Mailing Address - Fax:
Practice Address - Street 1:13458 110TH ST
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:KS
Practice Address - Zip Code:66066-5213
Practice Address - Country:US
Practice Address - Phone:816-718-9660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor