Provider Demographics
NPI:1285629741
Name:LETOURNEAU, KELLY PETER (DO)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:PETER
Last Name:LETOURNEAU
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1360 S WADSWORTH BLVD
Mailing Address - Street 2:208
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5415
Mailing Address - Country:US
Mailing Address - Phone:303-980-1222
Mailing Address - Fax:303-980-1119
Practice Address - Street 1:1360 S WADSWORTH BLVD
Practice Address - Street 2:208
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5415
Practice Address - Country:US
Practice Address - Phone:303-980-1222
Practice Address - Fax:303-980-1119
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CO43062204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM