Provider Demographics
NPI:1851736821
Name:MCDONALD, KELLY-ANN A (DC)
Entity Type:Individual
Prefix:DR
First Name:KELLY-ANN
Middle Name:A
Last Name:MCDONALD
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 1:3925 W BOYNTON BEACH BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4500
Mailing Address - Country:US
Mailing Address - Phone:561-336-4808
Mailing Address - Fax:
Practice Address - Street 1:6269 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-3175
Practice Address - Country:US
Practice Address - Phone:954-510-2225
Practice Address - Fax:754-206-1958
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor