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General NPI Number Information
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NPI Number | 1689736159
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Entity Type | Individual
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Provider Name | WILLIAM P KELLY D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 105 S PEARL ST
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City | TECUMSEH
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State | MI
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Zip | 49286-1951
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Country | US
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Telephone | 517-423-3600
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Fax | 517-423-1452
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Provider Business Mailing Address
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Address Line | 2900 PACKARD RD STE 2
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City | YPSILANTI
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State | MI
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Zip | 48197-2061
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Country | US
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Telephone | 734-677-0111
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Fax | 734-677-0135
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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 | 2301009278
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License Number State | MI
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