Organization
LONGMONT PSYCHIATRIC ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEVERANCE B KELLEY M.D (PRESIDENT OF THE CORPORATION)
(303) 772-3644
Entity
Organization
Contact information
Practice address
1380 TULOP ST., SUITE P, LONGMONT, CO 80501
(303) 772-3644
(303) 772-0889
Mailing address
1380 TULOP ST., SUITE P, LONGMONT, CO 80501
(303) 772-3644
(303) 772-0889
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04171047
—
CO
Enumeration date
07/29/2008
Last updated
07/29/2008
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