Individual
DR. KELLY B. FAIRCLOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
11 HEYMAN LN, ALEXANDRIA, LA 71303-3574
(318) 448-8462
(318) 448-8486
Mailing address
11 HEYMAN LN, ALEXANDRIA, LA 71303-3574
(318) 448-8462
(318) 448-8486
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
915
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1936294
—
LA
Enumeration date
03/28/2006
Last updated
09/12/2019
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