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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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