Provider Demographics
NPI:1447393137
Name:MCKELLAR, TERRENCE K (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:K
Last Name:MCKELLAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1000 FAIRGROUNDS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2381
Mailing Address - Country:US
Mailing Address - Phone:636-947-4046
Mailing Address - Fax:636-947-6787
Practice Address - Street 1:1000 FAIRGROUNDS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2381
Practice Address - Country:US
Practice Address - Phone:636-947-4046
Practice Address - Fax:636-947-6787
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO004887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO16626OtherGROUP HEALTH PLAN
MO10144OtherMISSOURI BLUE CROSS BLUE
MO4450049OtherUNITED HEALTHCARE
MO122805OtherHEALTHLINK
MO4397546OtherAETNA
MO4450049OtherUNITED HEALTHCARE