Individual
DR. JEFFREY ALAN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
JK008789
MI
111NR0200X
Radiology Chiropractor
Primary
JK008789
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G30188
BCBS PIN
MI
01
—
0N24830
MEDICARE ID
MI
01
—
950G311530
BCBS PIN NUMBER
MI
01
—
JK008789
BCBS LICENSE NUMBER
MI
Enumeration date
05/11/2006
Last updated
02/16/2023
Update your record
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