Provider Demographics
NPI:1114966827
Name:CULHANE, KELLY J (DC)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:J
Last Name:CULHANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 S. HARRISON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218
Mailing Address - Country:US
Mailing Address - Phone:303-996-4663
Mailing Address - Fax:303-996-4665
Practice Address - Street 1:1777 S. HARRISON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:303-996-4663
Practice Address - Fax:303-996-4665
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2807111N00000X
CO6209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU89453Medicare UPIN
U89453Medicare UPIN
MA445612Medicare ID - Type Unspecified