Individual
JOHN WALTER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 N BROADWAY, DENVER, CO 80203-3917
(303) 722-0771
Mailing address
828 N BROADWAY APT 450, DENVER, CO 80203-2789
(317) 690-7901
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
IN.0002009559
CO
183700000X
Pharmacy Technician
IN.0002009559
CO
Other
Enumeration date
06/02/2023
Last updated
06/15/2023
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