Provider Demographics
NPI:1164721262
Name:MCKELVEY, JONI
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:
Last Name:MCKELVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 NORTH 7TH ST.
Mailing Address - Street 2:#5
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501
Mailing Address - Country:US
Mailing Address - Phone:970-260-2885
Mailing Address - Fax:
Practice Address - Street 1:2232 N 7TH ST
Practice Address - Street 2:#5
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7459
Practice Address - Country:US
Practice Address - Phone:970-260-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3665225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist