Individual
DR. KELLY NESVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
300 WEST OAKLAND AVE, AUSTIN, MN 55912
(507) 437-7781
(507) 437-2937
Mailing address
300 WEST OAKLAND AVE, AUSTIN, MN 55912
(507) 437-7781
(507) 437-2937
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4014MN
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
906S3WE
BLUE CROSS PROVIDER ID
MN
01
—
P00236504
RAILROAD MC ID
MN
Enumeration date
03/08/2007
Last updated
07/09/2007
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