Organization
J&S KELLY LLC
Active
Other names
Kellys Medical Equipment & Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM M KELLENBERGER (MANAGING MEMBER)
(563) 386-1553
Entity
Organization
Contact information
Practice address
730 E KIMBERLY RD, DAVENPORT, IA 52807-1621
(563) 386-1553
(563) 449-5450
Mailing address
730 E KIMBERLY RD, DAVENPORT, IA 52807-1621
(563) 386-1553
(563) 449-5450
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
W00200148
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0185272
—
IA
Enumeration date
06/20/2005
Last updated
03/28/2012
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