# WALDO WELLNESS GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Waldo Chiropractic Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972761187
- **Authorized official:** DR. RANDY LEE KELLERMAN D.C. (PRESIDENT/OWNER)
- **Authorized official phone:** (816) 333-2533

## Contact information

- **Practice address:** 7210 WORNALL RD, KANSAS CITY, MO 64114-1345
- **Practice address phone:** (816) 333-2533
- **Practice address fax:** (816) 333-2586
- **Mailing address:** 7210 WORNALL RD, KANSAS CITY, MO 64114-1345
- **Mailing address phone:** (816) 333-2533
- **Mailing address fax:** (816) 333-2586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2007030924 | MO | — |
| 207Q00000X | Family Medicine Physician | 33655 | MO | Yes |
| 225100000X | Physical Therapist | 20110310891 | MO | — |

## Other

- **Enumeration date:** 05/26/2008
- **Last updated:** 03/07/2013