Provider Demographics
NPI:1730268848
Name:KELLS, KRISTEN CARA (DC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:CARA
Last Name:KELLS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6210 LEHMAN DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918
Mailing Address - Country:US
Mailing Address - Phone:719-533-0303
Mailing Address - Fax:719-533-0304
Practice Address - Street 1:6210 LEHMAN DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-533-0303
Practice Address - Fax:719-533-0304
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor