KELLY CHIROPRACTIC CENTER OF WALLACE NPI 1821286527

NPI Information

NPI: 1821286527
Provider Name: KELLY CHIROPRACTIC CENTER OF WALLACE
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
112 MEDICAL VILLAGE DR
SUITE A
WALLACE, NC
ZIP 28466
Phone: (910) 285-9002
Get Directions

KELLY CHIROPRACTIC CENTER OF WALLACE is a chiropractor in Wallace, NC. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. KELLY CHIROPRACTIC CENTER OF WALLACE NPI is 1821286527. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

112 MEDICAL VILLAGE DR
SUITE A
WALLACE, NC
ZIP 28466-668
Phone: (910) 285-9002

The provider's authorized official is Chad Garrett Kelly .
The authorized official title is President and has the following contact phone number (910) 214-6887.

The enumeration date for this NPI number is 10/9/2007 and was last updated on 3/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		2714	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0841K	OTHER		BLUE CROSS BLUE SHIELD
2	2335718	MEDICARE PIN
3	890845C	MEDICAID	NORTH CAROLINA
4	0845C	OTHER		BLUE CROSS BLUE SHIELD
5	890841K	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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