Organization
CREATIVE CUSTOM FOOT ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW D. KELLY BOCPD (OWNER/PRACTITIONER)
(303) 669-3771
Entity
Organization
Contact information
Practice address
5500 E YALE AVE STE 110, DENVER, CO 80222-6930
(303) 669-3771
(303) 382-4600
Mailing address
5500 E YALE AVE STE 110, DENVER, CO 80222-6930
(303) 669-3771
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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