Healthcare Provider Details
I. General information
NPI: 1114991205
Provider Name (Legal Business Name): KELLIE STEEN REED D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/15/2006
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8999 ST CHARLES ROCK ROAD
ST LOUIS MO
63114
US
IV. Provider business mailing address
8999 ST CHARLES ROCK ROAD
ST LOUIS MO
63114
US
V. Phone/Fax
- Phone: 314-428-3343
- Fax: 314-428-3338
- Phone: 314-428-3343
- Fax: 314-428-3338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 005843 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: