Individual
DR. TIMOTHY KENNETH KELM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1660 HIGHWAY 100 S, SUITE 145, ST LOUIS PARK, MN 55416-1529
(952) 456-6160
Mailing address
1660 HIGHWAY 100 S, SUITE 145, ST LOUIS PARK, MN 55416-1529
(952) 456-6160
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4573
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
378L7PI
BCBS PROVIDER GROUPNUMBER
MN
01
—
378L8KE
BCBS INDIVIDUAL PROVIDER
MN
Enumeration date
10/17/2006
Last updated
10/08/2012
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