Provider Demographics
NPI:1720835358
Name:KELLS, HOLLI JO MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:HOLLI
Middle Name:JO MARIE
Last Name:KELLS
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 1:3555 40TH AVE S APT 211
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-3590
Mailing Address - Country:US
Mailing Address - Phone:763-498-2152
Mailing Address - Fax:
Practice Address - Street 1:4551 S WASHINGTON ST STE K
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-3495
Practice Address - Country:US
Practice Address - Phone:701-787-1319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor