Provider Demographics
NPI:1235305525
Name:FAMILY, HEALTH, AND SPORTS CHIROPRACTIC
Entity Type:Organization
Organization Name:FAMILY, HEALTH, AND SPORTS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-775-4259
Mailing Address - Street 1:828 KIMBARK ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-4913
Mailing Address - Country:US
Mailing Address - Phone:303-775-4259
Mailing Address - Fax:303-678-3856
Practice Address - Street 1:828 KIMBARK ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4913
Practice Address - Country:US
Practice Address - Phone:303-775-4259
Practice Address - Fax:303-678-3856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5191261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center