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NPI Code Detail

MEDICARE: DR. JOHN HOWARD KELLENBERGER SR. DC

MEDICARE:  DR. JOHN HOWARD KELLENBERGER SR. DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH2118FL

General Provider Information

NPI Number : 1003065202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN HOWARD KELLENBERGER SR. DC
Provider Business Mailing Address
First Line : 256 CAVILLER CT
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33917-2985
Country : US
Telephone Number : 239-656-0091
Fax Number : 239-489-1314
Provider Business Practice Location Address
First Line : 14090 METROPOLIS AVE
Second Line : SUITE 101
City : FORT MYERS
State : FL
Zip : 33912-4450
Country : US
Telephone Number : 239-489-4100
Fax Number : 239-489-1314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2008
Last Update Date : 09/11/2008

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Directions to “ DR. JOHN HOWARD KELLENBERGER SR. DC” Practice Location

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