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Kelly J. Roush Icenhower, DC
Chiropractor in Gallipolis, Ohio
NPI 1629018320

Kelly J. Roush Icenhower is a Chiropractor based in Gallipolis, OH. Kelly J. Roush Icenhower practices in Gallipolis, OH and has the professional credentials of DC. The NPI Number for Kelly J. Roush Icenhower is 1629018320 and holds a License No. 2510 (Ohio).

The current practice location address for Kelly J. Roush Icenhower is 1051 4Th Ave, Gallipolis, OH and can be reached out via phone at 740-446-5244 and via fax at 740-446-5565.

Location: 1051 4Th Ave, Gallipolis, OH, 45631-1560
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629018320
Provider Name
Kelly J. Roush Icenhower
Credential
DC
Provider Entity Type
Individual
Gender
Female
Address
1051 4Th Ave, Gallipolis, OH, 45631-1560
Phone Number
740-446-5244
Fax Number
740-446-5565
Provider Enumeration Date
06/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
350039394 01 RR MEDICARE
000000185276 01 OH UNISON MEDICAID
2026677 05 OH
000000007692 01 ANTHEM BCBS
0132242000 05 WV
001714092 01 MOUNTAIN STATE BCBS
310917085149 01 OH CARESOURCE MEDICAID
institution
Provider Business Practice Location Address Details
Address
1051 4Th Ave
City
Gallipolis
State
Ohio
Zip
45631-1612
Phone Number
740-446-5244
Fax Number
740-446-5565
person
Provider Business Mailing Address Details
Address
1051 4Th Ave
City
Gallipolis
State
Ohio
Zip
45631-1612
Phone Number
740-446-5244
Fax Number
740-446-5565
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
2510 (West Virginia)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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