Provider Demographics
NPI:1336480219
Name:KELSEY, MICHAEL SHELDON (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SHELDON
Last Name:KELSEY
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 1:4019 E SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0215
Mailing Address - Country:US
Mailing Address - Phone:702-452-5000
Mailing Address - Fax:702-452-8609
Practice Address - Street 1:4019 E SUNSET RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0215
Practice Address - Country:US
Practice Address - Phone:702-452-5000
Practice Address - Fax:702-452-8609
Is Sole Proprietor?:No
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor