Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 14121 | TX |
NPI | 1346802220 |
---|---|
Provider Name | Dr. Kelsy Morgan Demelo |
First Address | Houston, TX 77019-4354 |
Second Address | Houston, TX 77019-4354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2019 |
Last Update Date | 01/07/2019 |