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General NPI Number Information
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NPI Number | 1740300870
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Entity Type | Individual
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Provider Name | KENNA S DUCEY-CLARK D.C., P.C.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 248 S GARFIELD ST STE 100
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City | DENVER
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State | CO
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Zip | 80209-3120
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Country | US
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Telephone | 303-810-5729
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MONROE ST
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City | DENVER
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State | CO
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Zip | 80206-5572
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Country | US
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Telephone | 303-320-1993
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Fax | 303-320-4599
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5033
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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