Individual
KELLY JEAN FORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BC-HIS
Contact information
Practice address
802 S CANTON AVE, SPRINGFIELD, MO 65802-4978
(417) 864-9886
Mailing address
802 S CANTON AVE, SPRINGFIELD, MO 65802-4978
(417) 864-9886
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2001032028
MO
Other
Enumeration date
06/29/2007
Last updated
07/09/2007
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