Organization
KELLEY CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI SWARTZ (OWNER)
(715) 568-4220
Entity
Organization
Contact information
Practice address
1503 LARSON ST, BLOOMER, WI 54724-1632
(715) 568-4220
(715) 568-4201
Mailing address
1503 LARSON ST, BLOOMER, WI 54724-1632
(715) 568-4220
(715) 568-4201
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2014-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38796100
—
WI
01
—
392035966010
BCBS
WI
Enumeration date
02/21/2007
Last updated
02/01/2021
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