MEDICARE: DR. REGINA KELLY-ROBERTS D.C.

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	2301008876	MI

General Provider Information

NPI Number	:	1962609834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REGINA KELLY-ROBERTS D.C.

Provider Business Mailing Address
First Line	:	32 S SQUIRREL RD
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-3287
Country	:	US
Telephone Number	:	248-289-6870
Fax Number	:	248-289-6871

Provider Business Practice Location Address
First Line	:	3396 E WEST MAPLE RD
Second Line	:
City	:	COMMERCE TWP
State	:	MI
Zip	:	48390-3807
Country	:	US
Telephone Number	:	248-960-3599
Fax Number	:	248-960-3599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	01/24/2024

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