Provider Demographics
NPI:1346606555
Name:HUDSON, CARLY (DC)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:
Other - Last Name:KAATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3365 W 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4952
Mailing Address - Country:US
Mailing Address - Phone:617-447-0228
Mailing Address - Fax:
Practice Address - Street 1:1805 S BELLAIRE ST
Practice Address - Street 2:SUITE 320
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4952
Practice Address - Country:US
Practice Address - Phone:303-955-7234
Practice Address - Fax:303-955-7234
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor