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General NPI Number Information
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NPI Number | 1215461959
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Entity Type | Organization
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Legal Business Name | RAE FRANCIS KELLY DC A PROFESSIONAL CORP
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 1405 ARVILLE ST STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89102-0539
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Country | US
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Telephone | 702-870-9200
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Fax | 702-870-9219
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Provider Business Mailing Address
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Address Line | 1405 ARVILLE ST STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89102-0539
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Country | US
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Telephone | 702-870-9200
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Fax | 702-870-9219
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAE FRANCIS KELLY
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Credential | DC
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Telephone | 702-870-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B00300
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License Number State | NV
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