MEDICARE: TIMOTHY KELLY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR002569	GA

General Provider Information

NPI Number	:	1245448604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY KELLY, INC.

Provider Business Mailing Address
First Line	:	3098 PIEDMONT RD NE
Second Line	:	SUITE 430
City	:	ATLANTA
State	:	GA
Zip	:	30305-2600
Country	:	US
Telephone Number	:	404-477-1589
Fax Number	:	770-992-3676

Provider Business Practice Location Address
First Line	:	3098 PIEDMONT RD NE
Second Line	:	SUITE 430
City	:	ATLANTA
State	:	GA
Zip	:	30305-2600
Country	:	US
Telephone Number	:	404-477-1589
Fax Number	:	770-992-3676

Authorized Official
Title or Position	:	DC / OWNER
Name	:	TIMOTHY P KELLY
Credential	:	DC
Telephone Number	:	404-477-1589

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	06/21/2018

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Directions to “TIMOTHY KELLY, INC. ” Practice Location

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