Healthcare Provider Details

I. General information

NPI: 1316877251
Provider Name (Legal Business Name): KELSEY FOSTER-GOODRICH
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: SPROUT FOSTER-GOODRICH

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N GRANT ST
DENVER CO
80203-3524
US

IV. Provider business mailing address

1151 N MARION ST
DENVER CO
80218-4303
US

V. Phone/Fax

Practice location:
  • Phone: 303-863-8330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0024630
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: