| Timothy M Kelley Dc Pllc | |
|
94 State St Heuvelton NY 13654 | |
| (315) 344-7296 | |
| (315) 344-7296 |
| Full Name | Timothy M Kelley Dc Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 94 State St, Heuvelton, New York |
| Authorized Official Name and Position | Timothy Michael Kelley (OWNER) |
| Authorized Official Contact | 3153447296 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy M Kelley Dc Pllc 94 State St Heuvelton NY 13654 Ph: (315) 344-7296 | Timothy M Kelley Dc Pllc 94 State St Heuvelton NY 13654 Ph: (315) 344-7296 |
| NPI Number | 1104093749 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 05/13/2008 |
| Medicare PECOS PAC ID | 1951478882 |
|---|---|
| Medicare Enrollment ID | O20080918000498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104093749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | X011547-1 (New York) | Primary |
| Provider Name | Timothy M Kelley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356443972 PECOS PAC ID: 8123037702 Enrollment ID: I20080918000492 |
Claxton Hepburn Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Rensselaer St, Heuvelton, NY 13654 Phone: 315-344-6621 Fax: 315-713-6510 | |
Carthage Area Hospital Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Rensselaer St, Heuvelton, NY 13654 Phone: 315-344-6621 |