Individual
MRS. KELLEY R JACKSON CONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1409 WASHINGTON AVE, GOLDEN, CO 80401
(303) 271-1400
(303) 271-9314
Mailing address
1409 WASHINGTON AVE, GOLDEN, CO 80401
(303) 271-1400
(303) 271-9314
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CO1678
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08016784
—
CO
Enumeration date
08/21/2006
Last updated
03/04/2009
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