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General NPI Number Information
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NPI Number | 1306240445
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Entity Type | Individual
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Provider Name | KELLIE AFFOLDER
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 12008 MELODY DR
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City | WESTMINSTER
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State | CO
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Zip | 80234-4212
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Country | US
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Telephone | 303-255-1047
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Fax |
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Provider Business Mailing Address
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Address Line | 8450 DECATUR ST APT 113
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City | WESTMINSTER
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State | CO
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Zip | 80031-3824
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Country | US
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Telephone | 303-513-7080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 15492
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License Number State | CO
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