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General NPI Number Information
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NPI Number | 1649998816
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Entity Type | Individual
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Provider Name | ASHLEY KELLEY DC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 400 S ZANG BLVD STE 200
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City | DALLAS
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State | TX
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Zip | 75208-6638
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Country | US
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Telephone | 972-392-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 6825 WILHELMINA DR
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City | DALLAS
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State | TX
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Zip | 75237-2577
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Country | US
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Telephone | 469-648-9839
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 15274
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License Number State | TX
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