Kadolph, Kelly Jay

Kadolph, Kelly Jay is an sole proprietor health care provider with primary practice located at 3307 Miller St , Bethany MO 64424-2716. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Kadolph, Kelly Jay can be contacted via phone (660) 425-3312.

Contact Information

Primary practice address
3307 Miller St Bethany MO 64424-2716
Phone: (660) 425-3312
Fax: (660) 425-3438
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 005205 Missouri

Profile Details

NPI number 1639114366
LBN Legal business name Kadolph, Kelly Jay
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 17th, 2006
Last updated Jan 16th, 2014 - about 10 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 1639114366 NPPES
Missouri Other 20768013 BLUE CROSS BLUE SHIELD

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