Provider Demographics
NPI:1235499401
Name:DUFFNER, KELLY (DC)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:DUFFNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 SPRINGFIELD PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2193
Mailing Address - Country:US
Mailing Address - Phone:513-445-4808
Mailing Address - Fax:513-445-4808
Practice Address - Street 1:1429 SPRINGFIELD PIKE STE C
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-2193
Practice Address - Country:US
Practice Address - Phone:513-445-4808
Practice Address - Fax:513-445-4808
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor