Provider Demographics
NPI:1154731842
Name:LLOYD, KELSEY (DC)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:
Last Name:LLOYD
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 1:4677 WYNGATE WAY
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-9243
Mailing Address - Country:US
Mailing Address - Phone:651-248-1841
Mailing Address - Fax:
Practice Address - Street 1:1211 JACKSON ST NE
Practice Address - Street 2:SUITE 121
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413
Practice Address - Country:US
Practice Address - Phone:651-353-6293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor