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NPI Code Detail

MEDICARE: TODD F KELLEHER DC PC

MEDICARE: TODD F KELLEHER DC PC
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
1111N00000XChiropractorCHIR005698GA

General Provider Information

NPI Number : 1497968739
Entity Type Code : Organization
Provider Name (Legal Business Name) : TODD F KELLEHER DC PC
Provider Business Mailing Address
First Line : PO BOX 2320
Second Line :
City : GRAY
State : GA
Zip : 31032-2320
Country : US
Telephone Number : 478-986-6444
Fax Number : 478-986-1254
Provider Business Practice Location Address
First Line : 4292 GRAY HWY
Second Line :
City : GRAY
State : GA
Zip : 31032-5900
Country : US
Telephone Number : 478-986-6444
Fax Number : 478-986-1254
Authorized Official
Title or Position : OWNER DOCTOR
Name : DR. TODD F KELLEHER
Credential : D.C.
Telephone Number : 478-986-6444
Provider Enumeration Date : 05/07/2007
Last Update Date : 03/14/2013

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