Individual
DR. KELLY R GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1906 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4227
(970) 384-6730
Mailing address
1906 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4227
(970) 384-6730
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
49141
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07987846
—
CO
Enumeration date
05/15/2007
Last updated
07/21/2022
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