Individual
DR. BRIAN SCOTT KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
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
06/30/2005
Last updated
07/08/2007
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