Individual
DR. KELLY DAVID REMILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1122 W DIVIDE AVE, BISMARCK, ND 58501-1202
(701) 258-5058
(701) 258-1041
Mailing address
1122 W DIVIDE AVE, BISMARCK, ND 58501-1202
(701) 258-5058
(701) 258-1041
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
736
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13407
—
ND
01
—
25373
BCBS PIN NUMBER
ND
Enumeration date
08/29/2006
Last updated
02/26/2025
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