Individual
MRS. KELLIE DAWN STENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D., P.C.
Contact information
Practice address
193 S 27TH AVE, SUITE 400, BRIGHTON, CO 80601-2661
(303) 654-7933
(303) 637-9002
Mailing address
193 S 27TH AVE, SUITE 400, BRIGHTON, CO 80601-2661
(303) 654-7933
(303) 637-9002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1833
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
841381269
TAX ID
CO
Enumeration date
11/05/2007
Last updated
10/31/2013
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