Individual
MARC STEPHEN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909-5533
(719) 457-6200
Mailing address
PO BOX 673, MONUMENT, CO 80132-0673
(719) 457-6200
(719) 487-0005
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
40518
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000152750
—
CO
Enumeration date
01/09/2007
Last updated
07/01/2020
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