MEDICARE: KELLY J ALLEN 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
1	111N00000X	Chiropractor	DC-004321-L	PA

General Provider Information

NPI Number	:	1366405797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY J ALLEN DC

Provider Business Mailing Address
First Line	:	1104 DARLINGTON RD
Second Line	:
City	:	BEAVER FALLS
State	:	PA
Zip	:	15010-2829
Country	:	US
Telephone Number	:	724-846-3600
Fax Number	:	724-846-5448

Provider Business Practice Location Address
First Line	:	1104 DARLINGTON RD
Second Line	:
City	:	BEAVER FALLS
State	:	PA
Zip	:	15010-2829
Country	:	US
Telephone Number	:	724-846-3600
Fax Number	:	724-846-5448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	09/02/2008

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