Organization
BOULDER VALLEY CENTER FOR DERMATOLOGY LLC
Active
Organization
BOULDER VALLEY CENTER FOR DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY KENYON (PRACTICE ADMIN)
(720) 308-7714
Entity
Organization
Contact information
Practice address
1610 PRAIRIE CENTER PKWY STE 2230, BRIGHTON, CO 80601-4008
(303) 604-1444
(303) 666-0911
Mailing address
PO BOX 272308, FORT COLLINS, CO 80527-2308
(303) 604-1444
(970) 484-2251
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/07/2020
Last updated
09/03/2024
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