Provider Demographics
NPI:1114991205
Name:REED, KELLIE STEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:KELLIE
Middle Name:STEEN
Last Name:REED
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 1:8999 ST CHARLES ROCK ROAD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114
Mailing Address - Country:US
Mailing Address - Phone:314-428-3343
Mailing Address - Fax:314-428-3338
Practice Address - Street 1:8999 ST CHARLES ROCK ROAD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114
Practice Address - Country:US
Practice Address - Phone:314-428-3343
Practice Address - Fax:314-428-3338
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4401950OtherUNITED HEALTHCARE PIN
MO5477588OtherAETNA PIN
MO1928OtherBLUE CROSS GROUP PIN
MO274089OtherHEALTHLINK PIN
MO29102OtherBLUE CROSS PIN
MO000032527Medicare PIN
MO29102OtherBLUE CROSS PIN