| Dr Kellys House Calls | |
| 
					S57w29735 Saylesville Rd Waukesha WI 53189-9036  | |
| (262) 287-0903 | |
| Not Available | 
| Full Name | Dr Kellys House Calls | 
|---|---|
| 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 | 
|---|---|
| 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 | 
|---|---|
| Provider Enumeration Date | 12/06/2017 | 
| Last Update Date | 12/06/2017 | 
| Medicare PECOS PAC ID | 7416210307 | 
|---|---|
| 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 | 
|---|---|
| Provider Type | Practitioner - Chiropractic | 
| Provider Identifiers | NPI Number: 1104844430 PECOS PAC ID: 7113914607 Enrollment ID: I20040427001238  | 
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