Provider Demographics
NPI:1972876001
Name:KELLEY, CHRISTOPHER HORI (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:HORI
Last Name:KELLEY
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 1:151 N SUNRISE AVE
Mailing Address - Street 2:STE 701
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2927
Mailing Address - Country:US
Mailing Address - Phone:916-786-5828
Mailing Address - Fax:916-786-5055
Practice Address - Street 1:151 N SUNRISE AVE
Practice Address - Street 2:SUITE 907
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2924
Practice Address - Country:US
Practice Address - Phone:916-786-5828
Practice Address - Fax:916-786-5055
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 32218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 32218OtherCA STATE LICENSE