Individual
DR. JEFFREY ALAN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4266 STATE ST, SAGINAW, MI 48603-4028
(989) 792-6702
(989) 792-1128
Mailing address
2605 S GRAHAM RD, SAGINAW, MI 48609-9616
(989) 642-5421
(989) 792-1128
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
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