Provider Demographics
NPI:1710708136
Name:KIMMEL, SANDI (RDMS, RVT)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:
Last Name:KIMMEL
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11212 ENDEAVOR DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3830
Mailing Address - Country:US
Mailing Address - Phone:720-741-7255
Mailing Address - Fax:720-986-7998
Practice Address - Street 1:19751 E MAINSTREET STE R10
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7406
Practice Address - Country:US
Practice Address - Phone:720-741-7255
Practice Address - Fax:720-986-7998
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO926332085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound