Kelly J Wallis


Address: 6309 Corporate Ct Sw, Suite 110, Fort Myers, FL 33919-3539

Kelly J Wallis (NPI# 1952724395, PAC ID# 6507181898) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CHIROPRACTIC.

Physician Overview

Nation Provider ID (NPI) 1952724395
PAC ID by PECOS 6507181898
Professional Enrollment ID I20150209000480
Full Name Kelly J Wallis
Address 6309 Corporate Ct Sw
Suite 110
Fort Myers
FL 33919-3539
Gender F
Graduation Year 2013
Primary Specialty CHIROPRACTIC
Accepts Medicare Assignment M

Other Locations

Address Phone Organization
6309 Corporate Ct Sw, Suite 110, Fort Myers, FL 33919-3539

Organization Information

Office Location

Street Address 6309 CORPORATE CT SW
SUITE 110
City FORT MYERS
State FL
Zip 33919-3539

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Competitor

Search similar physicians

City FORT MYERS
Zip Code 33919
Specialty CHIROPRACTIC
City + Specialty FORT MYERS + CHIROPRACTIC

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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