Kelly, John

Kelly, John is an individual health care provider with primary practice located at 4048 Crestwood Dr , Wausau WI 54403-8122. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Kelly, John can be contacted via phone (715) 370-5646.

Contact Information

Primary practice address
4048 Crestwood Dr Wausau WI 54403-8122
Phone: (715) 370-5646
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1952969826
LBN Legal business name Kelly, John
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2019
Last updated Jun 4th, 2019 - about 6 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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