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Individual

KENNETH G. EIELSON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
6916 HIGHWAY 82, GLENWOOD SPRINGS, CO 81601-9435
(970) 945-2241
(970) 945-5523
Mailing address
2001 BLAKE AVE STE 1A, CHI/STORM KING CASE MANAGEMENT, GLENWOOD SPRINGS, CO 81601-4269
(970) 945-8669
(970) 947-9158

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6098
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6098
OLORADO DEPARTMENT OF REGULARTORY AGENCIES/CAC CERTIFICATION
CO
Enumeration date
01/17/2009
Last updated
03/11/2009
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