Kelley, Brian Scott

Kelley, Brian Scott is an sole proprietor health care provider with primary practice located at 1503 Larson St , Bloomer WI 54724-1632. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Kelley, Brian Scott can be contacted via phone (715) 568-4220.

Contact Information

Primary practice address
1503 Larson St Bloomer WI 54724-1632
Phone: (715) 568-4220
Fax: (715) 568-4201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 2014-012 Wisconsin

Profile Details

NPI number 1811994205
LBN Legal business name Kelley, Brian Scott
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2005
Last updated Jul 8th, 2007 - about 17 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 1811994205 NPPES
Wisconsin Other 392035966010 BCBS
Wisconsin MEDICAID 38796100 BCBS

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