Provider Demographics
NPI:1043203144
Name:CONLEY, COURTNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:CONLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 17TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:IDAHO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80452
Mailing Address - Country:US
Mailing Address - Phone:303-408-0038
Mailing Address - Fax:630-737-0310
Practice Address - Street 1:222 17TH AVENUE
Practice Address - Street 2:
Practice Address - City:IDAHO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80452
Practice Address - Country:US
Practice Address - Phone:303-408-0038
Practice Address - Fax:630-737-0310
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009959111N00000X
COCHR-6413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor