Individual
RONALD KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11113 BIRCH HOLLOW WAY, PEYTON, CO 80831-5037
(719) 574-7781
Mailing address
11113 BIRCH HOLLOW WAY, PEYTON, CO 80831-5037
(719) 574-7781
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA-1258
CO
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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