Brian Scott Kelley in Bloomer - Sports Physician
Brian Scott Kelley - NPI 1811994205
Brian Scott Kelley is a Sports Physician in Bloomer, Wisconsin. Brian Scott Kelley practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Brian Scott Kelley is 1811994205. The last update date is 2007-07-08.
Brian Scott Kelley's current location address is 1503 Larson St, Bloomer, Wisconsin. You can contact this provider via phone number 7155684220 and fax number 7155684201. The mailing address for Brian Scott Kelley is 1503 Larson St, Bloomer, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brian Scott Kelley |
|---|---|
| Address | 1503 Larson St, Bloomer, Wisconsin |
| Phone Number | 7155684220 |
| Fax Number | 7155684201 |
| Sole Proprietor | Y |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1811994205 |
|---|---|
| Provider Enumeration Date | 2005-06-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1503 Larson St |
|---|---|
| City | Bloomer |
| State | Wisconsin (WI) |
| Post Code | 547241632 |
| Phone Number | 7155684220 |
| Fax Number | 7155684201 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | 2014-012 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 392035966010 | WI | BCBS | |
| 38796100 | WI | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Brian Scott Kelley by the Centers for Medicare & Medicaid Services?
The Brian Scott Kelley has been assigned the NPI (National Provider Identifier) 1811994205 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Brian Scott Kelley is located?
The Brian Scott Kelley is situated at the following address: 1503 Larson St, Bloomer, WI, 547241632.
What is the Brian Scott Kelley's specialty and taxonomy code?
The Brian Scott Kelley's specialty is Sports Physician, and the corresponding taxonomy code is 111Ns0005X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1811994205 to Brian Scott Kelley?
The Centers for Medicare & Medicaid Services originally issued the 1811994205 to Brian Scott Kelley on 2005-06-30.
When was the Brian Scott Kelley's information last updated?
The Brian Scott Kelley's information was last updated on 2007-07-08.
NPI Number: 1588667679
Address: 9104 Babcock Blvd, Pittsburgh, PA