Kelly, Jack

Kelly, Jack is an individual health care provider with primary practice located at 68084 Lasalle Rd , Montrose CO 81401-7502. He recently has only one registered license in Other Service Providers / Home Modifications, which is considered as his primary health care specialty. Kelly, Jack can be contacted via phone (720) 648-6040.

Contact Information

Primary practice address
68084 Lasalle Rd Montrose CO 81401-7502
Phone: (720) 648-6040
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Home Modifications 171WH0202X

Profile Details

NPI number 1407562507
LBN Legal business name Kelly, Jack
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2023
Last updated Jan 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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