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Search › Wisconsin › 183500000X

Ciaran Kelly

NPI 1326647272 · on the registry since 2020 · sole proprietor

Practice

Address
2950 New Pinery Rd
Portage, WI 53901
Phone
(608) 742-1670
Organisation at this address
Wal-Mart Stores East Lp
Wal-Mart Stores East, Lp
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
183500000X
183500000X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-10-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin