Provider Demographics
NPI:1245253053
Name:KIRCHNER, KELLEY R (D C)
Entity type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:R
Last Name:KIRCHNER
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:R
Other - Last Name:WORKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:KAHOKA
Mailing Address - State:MO
Mailing Address - Zip Code:63445-0013
Mailing Address - Country:US
Mailing Address - Phone:660-727-3677
Mailing Address - Fax:660-727-2222
Practice Address - Street 1:374 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:KAHOKA
Practice Address - State:MO
Practice Address - Zip Code:63445-1453
Practice Address - Country:US
Practice Address - Phone:660-727-3677
Practice Address - Fax:660-727-2222
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006021033111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist