Individual
TODD ANTHONY KINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1120 WELLINGTON AVE, SUITE 206, GRAND JUNCTION, CO 81501-6129
(970) 243-7245
(970) 241-1308
Mailing address
1120 WELLINGTON AVE STE 206, GRAND JUNCTION, CO 81501-6131
(970) 243-7245
(970) 241-1308
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DR.0044198
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55230059
—
CO
01
—
P00366838
RAILROAD MEDICARE
—
05
—
T0514
—
UT
Enumeration date
07/19/2006
Last updated
06/14/2019
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