Individual
DR. MATTHEW SPENCER KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
317 CLARKSON RD, ELLISVILLE, MO 63011-2271
(636) 391-3937
Mailing address
15976 DOWNALL GREEN DR, CHESTERFIELD, MO 63017-7320
(314) 374-6831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2019035034
MO
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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