Organization
DETRICK & KELLY CHIROPRACTIC CLINIC INC
Active
Other names
East Otterman Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK KELLY JR. DC (OWNER)
(724) 838-7700
Entity
Organization
Contact information
Practice address
125 E OTTERMAN ST, GREENSBURG, PA 15601-2509
(724) 838-7700
(724) 838-7200
Mailing address
125 E OTTERMAN ST, GREENSBURG, PA 15601-2509
(724) 838-7700
(724) 838-7200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC007066L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1813203
—
PA
01
—
216189
UPMC
PA
01
—
410013
HEALTH AMERICA
PA
01
—
427398
BLUE SHIELD
PA
01
—
5840690
AETNA
PA
Enumeration date
06/06/2006
Last updated
05/07/2013
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