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Individual

KELLY KLOTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4674 SNOW MESA DR STE 200, FORT COLLINS, CO 80528-8614
(970) 266-3650
(970) 266-3660
Mailing address
4674 SNOW MESA DR STE 200, FORT COLLINS, CO 80528-8614
(970) 266-3650
(970) 266-3660

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.069264
IL
207R00000X
Internal Medicine Physician
Primary
DR.0064144
CO
208000000X
Pediatrics Physician
125.069264
IL
208000000X
Pediatrics Physician
DR.0064144
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000181978
CO
Enumeration date
06/16/2016
Last updated
06/17/2020
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