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General NPI Number Information
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NPI Number | 1639435944
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Entity Type | Organization
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Legal Business Name | KELCH CHIROPRACTIC INC.
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 2627 W ALTORFER DR STE A
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City | PEORIA
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State | IL
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Zip | 61615-1867
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Country | US
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Telephone | 309-693-8448
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Fax | 309-693-8438
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Provider Business Mailing Address
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Address Line | 7213 N ALLEN RD
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City | PEORIA
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State | IL
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Zip | 61614-1107
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Country | US
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Telephone | 309-693-8448
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Fax | 309-693-8438
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT D KELCH
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Credential | D.C.
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Telephone | 309-693-8448
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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 | 038011484
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License Number State | IL
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