Provider Demographics
NPI:1689045445
Name:PEARSALL, KENDRA (ND)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:
Last Name:PEARSALL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 952
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80502-0952
Mailing Address - Country:US
Mailing Address - Phone:970-673-7484
Mailing Address - Fax:
Practice Address - Street 1:14501 COUNTY ROAD 3
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-9648
Practice Address - Country:US
Practice Address - Phone:970-673-7484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath