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Contact Information

BRIAN S KELLEY, DC
1503 LARSON ST
BLOOMER, WI54724-1632
 Phone: 715-568-4220
 Fax: 715-568-4201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for BRIAN S KELLEY · (Male)

NPI Number 1811994205
Status Active
Credentials DC (Doctor of Chiropractic)
Entity Individual
Enumeration date 06/30/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 2014-012
  • WI Medicaid 38796100
  • WI Other 392035966010 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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