Provider Demographics
NPI:1245502566
Name:KENNETH ALLAN, LLC
Entity type:Organization
Organization Name:KENNETH ALLAN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-282-4707
Mailing Address - Street 1:7800 E ORCHARD RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2583
Mailing Address - Country:US
Mailing Address - Phone:720-282-4707
Mailing Address - Fax:815-642-4692
Practice Address - Street 1:7800 E ORCHARD RD
Practice Address - Street 2:SUITE 350
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2583
Practice Address - Country:US
Practice Address - Phone:720-282-4707
Practice Address - Fax:815-642-4692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center