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NPI Code Detail

MEDICARE: JOY KELLY

MEDICARE: JOY KELLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist0002860CO

General Provider Information

NPI Number : 1477181618
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY KELLY
Provider Business Mailing Address
First Line : 1306 SIOUX BLVD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-2590
Country : US
Telephone Number : 214-587-1494
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S LEMAY AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4262
Country : US
Telephone Number : 970-495-8780
Fax Number : 970-495-8799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2020
Last Update Date : 04/01/2020

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Directions to “ JOY KELLY ” Practice Location

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