Provider Demographics
NPI:1104939057
Name:TUELL, KEVANN LYNN (ATC)
Entity type:Individual
Prefix:MISS
First Name:KEVANN
Middle Name:LYNN
Last Name:TUELL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 YUMA CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-7035
Mailing Address - Country:US
Mailing Address - Phone:970-217-0100
Mailing Address - Fax:970-491-6167
Practice Address - Street 1:531 YUMA CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7035
Practice Address - Country:US
Practice Address - Phone:970-217-0100
Practice Address - Fax:970-491-6167
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist