Ryan Christopher Kelly, DC | |
10310 Feld Farm Ln Ste 100, Charlotte, NC 28210-8524 | |
(980) 297-0103 | |
Not Available |
Full Name | Ryan Christopher Kelly |
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Gender | Male |
Speciality | Chiropractor |
Location | 10310 Feld Farm Ln Ste 100, Charlotte, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245076702 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 5790 (North Carolina) | Primary |
Provider Name | Performance Rehab Associates Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1821342346 PECOS PAC ID: 1052564689 Enrollment ID: O20130110000380 |
Mailing Address | Practice Location Address |
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Ryan Christopher Kelly, DC 5115 Park Rd Apt 430, Charlotte, NC 28209-3884 Ph: (703) 772-4866 | Ryan Christopher Kelly, DC 10310 Feld Farm Ln Ste 100, Charlotte, NC 28210-8524 Ph: (980) 297-0103 |
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