Individual
DR. MARTY J KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2916 HAMILTON BLVD, SIOUX CITY, IA 51104-2429
(712) 255-1621
(712) 255-1389
Mailing address
2916 HAMILTON BLVD, SIOUX CITY, IA 51104-2429
(712) 255-1621
(712) 255-1389
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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