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NPI Code Detail

MEDICARE: DR. KELL W. FLESHOOD D.C.

MEDICARE: DR. KELL W. FLESHOOD D.C.
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
1111N00000XChiropractor432VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1333060OTHERVABCBS OF VA

General Provider Information

NPI Number : 1649284936
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELL W. FLESHOOD D.C.
Provider Business Mailing Address
First Line : PO BOX 794
Second Line :
City : SOUTH HILL
State : VA
Zip : 23970-0794
Country : US
Telephone Number : 434-447-8996
Fax Number : 434-955-2582
Provider Business Practice Location Address
First Line : 107 N BRUNSWICK AVE
Second Line :
City : SOUTH HILL
State : VA
Zip : 23970-1909
Country : US
Telephone Number : 434-447-8996
Fax Number : 434-955-2582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2006
Last Update Date : 02/12/2013

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