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1386315794
KELLY LEIGH KIERSTEAD
CANON CITY, CO
NPI
1386315794
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: CO PTA.0012399)
Enumeration Date
2021-09-24
Last Update Date
2021-09-24
Business Address
KELLY LEIGH KIERSTEAD PTA
515 FAIRVIEW AVE
CANON CITY, CO 81212-2863
Phone number: 719-275-0665
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Mailing Address
KELLY LEIGH KIERSTEAD PTA
PO BOX 161
ROCKVALE, CO 81244-0161
Phone number: 719-225-3967
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