Individual
KRISS LAWRENCE DELLOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(970) 495-8006
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40586
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117530100
—
WY
05
—
27607861
—
CO
05
—
55827847
—
NE
01
—
S5008
BCBS
—
Enumeration date
12/13/2005
Last updated
03/05/2014
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