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Individual

CHARLES R KELLY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4400 BROADWAY ST, STE 540, KANSAS CITY, MO 64111-3498
(816) 931-3013
Mailing address
4400 BROADWAY ST, STE 540, KANSAS CITY, MO 64111-3498

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0413279
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MDR4208
MO

Other

Enumeration date
08/16/2005
Last updated
07/08/2007
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