Provider Demographics
NPI:1225189426
Name:LEMELIN, KELLY (DC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:LEMELIN
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 1:128 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347-1346
Mailing Address - Country:US
Mailing Address - Phone:207-623-9355
Mailing Address - Fax:207-623-9354
Practice Address - Street 1:128 SECOND ST
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347-1346
Practice Address - Country:US
Practice Address - Phone:207-623-9355
Practice Address - Fax:207-623-9354
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME6530187OtherCIGNA
MEU27811OtherHARVARD PILGRIM HEALTHCAR
ME7704813OtherAETNA
MEP00302578OtherRAILROAD MEDICARE
ME7704813OtherAETNA
MEP00302578OtherRAILROAD MEDICARE