Individual
DR. JUSTIN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
8011 MARYLAND AVENUE, ST. LOUIS, MO 63105
(989) 619-4839
Mailing address
71 SAN TANA CT, CEDAR HILL, MO 63016
(989) 619-4839
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
111NS0005X
MO
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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