Provider Demographics
NPI:1467250837
Name:MANEAGE, KELLEY NICOLE (DC, ATC)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:NICOLE
Last Name:MANEAGE
Suffix:
Gender:
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 PAYNE DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-2450
Mailing Address - Country:US
Mailing Address - Phone:612-597-6434
Mailing Address - Fax:
Practice Address - Street 1:2004 CLOCK TOWER PL STE 110
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-6404
Practice Address - Country:US
Practice Address - Phone:785-320-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor