Individual
DR. KENNETH A KELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
639 W MAIN, SHERIDAN, OR 97378
(503) 843-3888
(503) 843-4366
Mailing address
PO BOX 37, SHERIDAN, OR 97378-0037
(503) 843-3888
(503) 843-4366
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
271343
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112941
KAISER PERMANENTE
OR
Enumeration date
02/01/2006
Last updated
07/08/2007
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