NPI 1427520634

Justin Kelly, DC

Practitioner Sports Physician Chiropractor St. Louis, MO

Practice location

Address: 8011 Maryland Avenue, St. Louis, MO 63105
Phone: (989) 619-4839
Mailing address: 71 San Tana CT, Cedar Hill, MO 63016

Registered specialties

Sports Physician Chiropractor Primary

Chiropractic Providers Taxonomy 111NS0005X Licence 111NS0005X (MO)

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Registry record

NPI: 1427520634
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Dec 2018
Record last updated: 28 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.