MEDICARE: MRS. JESSICA RUTH MCKELVEY 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
1	111N00000X	Chiropractor	B01858	NV

General Provider Information

NPI Number	:	1689990145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA RUTH MCKELVEY D.C.

Provider Business Mailing Address
First Line	:	370 CASA NORTE DR UNIT 2121
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-3332
Country	:	US
Telephone Number	:	725-910-2935
Fax Number	:

Provider Business Practice Location Address
First Line	:	4116 W CRAIG RD STE 100
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-2733
Country	:	US
Telephone Number	:	702-655-1199
Fax Number	:	702-646-0630

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

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	03/28/2023

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