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General NPI Number Information
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NPI Number | 1326058652
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Entity Type | Organization
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Legal Business Name | DONNA M KELLY DC PC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 36410 GARFIELD KELLY CHIROPRACTIC
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-1131
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Country | US
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Telephone | 586-792-5050
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Fax | 586-792-5298
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Provider Business Mailing Address
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Address Line | 36410 GARFIELD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-1131
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Country | US
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Telephone | 586-792-5050
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Fax | 586-792-5298
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Authorized Official
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Title or Position | CHIROPRACTOR PRES
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Name | MS. DONNA MARGARET KELLY
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Credential | DC
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Telephone | 586-792-5050
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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 | 2301005669
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License Number State | MI
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