Individual
KURT T DALLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR25057
CO
207QS0010X
Sports Medicine (Family Medicine) Physician
DR25057
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01250570
—
CO
01
—
P01645447
RR MEDICARE
CO
Enumeration date
12/07/2005
Last updated
12/16/2019
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