Provider Demographics
NPI:1992821953
Name:REED, KELLY ANDRE (DC)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANDRE
Last Name:REED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:326 S EDMONDS LN
Mailing Address - Street 2:104
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067
Mailing Address - Country:US
Mailing Address - Phone:972-436-2521
Mailing Address - Fax:940-567-8161
Practice Address - Street 1:326 S EDMONDS LN
Practice Address - Street 2:104
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3580
Practice Address - Country:US
Practice Address - Phone:972-436-2521
Practice Address - Fax:972-436-7246
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX10570111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor