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Individual
DR. MARTY J KELLEY
Active
Individual
DR. MARTY J KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00763
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0289124
—
IA
05
—
0435834
—
IA
05
—
10025293700
—
NE
Enumeration date
10/04/2005
Last updated
04/28/2008
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