Organization
PRIMARY INJURY CARE
Active
Organization
PRIMARY INJURY CARE
Active
Other names
Primary Injury Care and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
TRACE ROBERT KELLY DC, FNP (OWNER)
(502) 415-3943
Entity
Organization
Contact information
Practice address
2935 DOLPHIN DR STE 203, ELIZABETHTOWN, KY 42701-4112
(270) 900-0157
Mailing address
2935 DOLPHIN DR STE 203, ELIZABETHTOWN, KY 42701-4112
(270) 900-0157
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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