Provider Demographics
NPI:1679710917
Name:SIMON, KANDI (DC)
Entity Type:Individual
Prefix:DR
First Name:KANDI
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:KANDI
Other - Middle Name:
Other - Last Name:BELTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2227 N WEBER ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6946
Mailing Address - Country:US
Mailing Address - Phone:719-433-0750
Mailing Address - Fax:
Practice Address - Street 1:2227 N WEBER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6946
Practice Address - Country:US
Practice Address - Phone:719-433-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor