| Organization Name: | J&S KELLY LLC |
| NPI Number: | 1023356672 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM M KELLENBERGER (MANAGING MEMBER) |
| Mailing Address: | 1801 E 54th St Suite 200 Davenport |
| State: | IA US |
| Postal Code: | 528077209 |
| Phone Number: | 5633861553 |
| Fax Number: | 5634495450 |
| NPI Enumeration Date: | 01/16/2013 |
| NPI Last Update Date: | 01/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | =========003 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |