Organization
TERRI KELLEY
Active
Other names
Innovative Mobile Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KELLEY (PRESIDENT)
(417) 626-9729
Entity
Organization
Contact information
Practice address
1801 KATHERINE AVE, JOPLIN, MO 64801-5888
(417) 626-9729
(471) 206-4113
Mailing address
PO BOX 2966, 1801 KATHERINE ST, JOPLIN, MO 64803-2966
(417) 626-9729
(471) 206-4113
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
309
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200021670A
—
OK
05
—
200253180A
—
KS
05
—
719136509
—
MO
Enumeration date
01/19/2007
Last updated
01/12/2009
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