Kelly, Justin
Kelly, Justin is an sole proprietor health care provider with primary practice located at 8011 Maryland Avenue , St. Louis MO 63105. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Kelly, Justin can be contacted via phone (989) 619-4839.Contact Information
Primary practice address
8011 Maryland Avenue
St. Louis MO 63105
Phone: (989) 619-4839
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Sports Physician | 111NS0005X | 111NS0005X | Missouri |
Profile Details
| NPI number | 1427520634 |
|---|---|
| LBN Legal business name | Kelly, Justin |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 28th, 2018 |
| Last updated | Dec 28th, 2018 - 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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