Davis, Kelly Anne

Davis, Kelly Anne is an individual health care provider with primary practice located at 808 Tiger Blvd Suite D, Bentonville AR 72712. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Davis, Kelly Anne can be contacted via phone (479) 271-4438.

Contact Information

Primary practice address
808 Tiger Blvd Suite D Bentonville AR 72712
Fax: (479) 271-4438
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2004002392 Missouri
Chiropractic Providers / Chiropractor 111N00000X 1637 Arkansas

Profile Details

NPI number 1376755413
LBN Legal business name Davis, Kelly Anne
Credentials BS DC
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Mar 2nd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376755413 NPPES
Arkansas Other 5Y064 BCBS
Arkansas MEDICAID 156021718 BCBS
Arkansas Other P00166048 BCBS

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