Provider Demographics
NPI:1598389801
Name:KASTEIN, CHELSEA ANN (DC)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:KASTEIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:MOLDENHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:505 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:GREEN LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54941-0458
Mailing Address - Country:US
Mailing Address - Phone:920-294-3130
Mailing Address - Fax:855-410-0730
Practice Address - Street 1:505 LAKE ST
Practice Address - Street 2:
Practice Address - City:GREEN LAKE
Practice Address - State:WI
Practice Address - Zip Code:54941-0458
Practice Address - Country:US
Practice Address - Phone:920-294-3130
Practice Address - Fax:855-410-0730
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5543-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor