Provider Demographics
NPI:1669003992
Name:EVERLEY, KELSEY K (DC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:K
Last Name:EVERLEY
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 1:622 N MADISON AVE STE 7AND8
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-4082
Mailing Address - Country:US
Mailing Address - Phone:317-885-8520
Mailing Address - Fax:
Practice Address - Street 1:622 N MADISON AVE STE 7AND8
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-4082
Practice Address - Country:US
Practice Address - Phone:317-885-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003148A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor