Rhoades, Kelly Dan

Rhoades, Kelly Dan is an individual health care provider with primary practice located at 235 W Commercial St , Lebanon MO 65536-3145. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Rhoades, Kelly Dan can be contacted via phone (417) 532-6359.

Contact Information

Primary practice address
235 W Commercial St Lebanon MO 65536-3145
Phone: (417) 532-6359
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2007015291 Missouri

Profile Details

NPI number 1417152414
LBN Legal business name Rhoades, Kelly Dan
Credentials PLPC, MA
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2007
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 1417152414 NPPES
Missouri MEDICAID 1437228905

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