Provider Demographics
NPI:1154828317
Name:FLORY, KALE (DO)
Entity Type:Individual
Prefix:
First Name:KALE
Middle Name:
Last Name:FLORY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FAMILY MEDICINE CENTER
Mailing Address - Street 2:1025 PENNOCK PLACE
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524
Mailing Address - Country:US
Mailing Address - Phone:970-495-8800
Mailing Address - Fax:970-495-8891
Practice Address - Street 1:FAMILY MEDICINE CENTER
Practice Address - Street 2:1025 PENNOCK PLACE
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524
Practice Address - Country:US
Practice Address - Phone:970-495-8800
Practice Address - Fax:970-495-8891
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0063018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program