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Individual

DR. KELLY VERNON REAGAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
300 E WATER ST, DECORAH, IA 52101-1922
(563) 382-4411
(563) 382-2124
Mailing address
300 E WATER ST, DECORAH, IA 52101-1922
(563) 382-4411
(563) 382-2124

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05825
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1119982
IA
Enumeration date
08/24/2005
Last updated
07/08/2007
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