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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