Individual
KELLY LYNN COMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
300 W OTTLEY AVE, FRUITA, CO 81521-2118
(970) 858-3900
(970) 858-2743
Mailing address
PO BOX 130, FRUITA, CO 81521-0130
(970) 858-2186
(970) 858-2208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0048539
CO
207R00000X
Internal Medicine Physician
OT012538
PA
Other
Enumeration date
07/21/2008
Last updated
11/23/2020
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