Individual
MS. KELLY JO FABRIZIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SAC
Contact information
Practice address
200 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(970) 674-9766
Mailing address
508 MALLARD DR, WINDSOR, CO 80550-2923
(970) 674-9766
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CO8-0320A
CO
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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