Provider Demographics
NPI:1003167032
Name:CONANT, KELLEE (DC)
Entity Type:Individual
Prefix:DR
First Name:KELLEE
Middle Name:
Last Name:CONANT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15364 S. TELEGRAPH RD.
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-4070
Mailing Address - Country:US
Mailing Address - Phone:734-241-1191
Mailing Address - Fax:734-241-0800
Practice Address - Street 1:15364 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-4070
Practice Address - Country:US
Practice Address - Phone:734-241-1191
Practice Address - Fax:734-241-0800
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor