Individual
DR. KELLY ANNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS DC
Contact information
Practice address
808 TIGER BLVD, SUITE D, BENTONVILLE, AR 72712
(479) 271-4438
(479) 271-4438
Mailing address
808 TIGER BLVD, SUITE D, BENTONVILLE, AR 72712
(479) 271-4438
(479) 271-4438
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1637
AR
111N00000X
Chiropractor
2004002392
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156021718
—
AR
01
—
5Y064
BCBS
AR
01
—
P00166048
RR MEDICARE
—
Enumeration date
05/03/2007
Last updated
03/02/2012
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