Dr Kellys House Calls | |
S57w29735 Saylesville Rd Waukesha WI 53189-9036 | |
(262) 287-0903 | |
Not Available |
Full Name | Dr Kellys House Calls |
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Speciality | Clinic/Center |
Location | S57w29735 Saylesville Rd, Waukesha, Wisconsin |
Authorized Official Name and Position | Kelly Joan Wolf (OWNER/ CHIROPRACTOR) |
Authorized Official Contact | 2622870903 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dr Kellys House Calls S57w29735 Saylesville Rd Waukesha WI 53189-9036 Ph: (262) 287-0903 | Dr Kellys House Calls S57w29735 Saylesville Rd Waukesha WI 53189-9036 Ph: (262) 287-0903 |
NPI Number | 1841705332 |
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Provider Enumeration Date | 12/06/2017 |
Last Update Date | 12/06/2017 |
Medicare PECOS PAC ID | 7416210307 |
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Medicare Enrollment ID | O20180405001487 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841705332 | NPI | - | NPPES |
38947400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 3919-012 (Wisconsin) | Primary |
Provider Name | Kelly J Anello |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1104844430 PECOS PAC ID: 7113914607 Enrollment ID: I20040427001238 |
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