Provider Demographics
NPI:1639471592
Name:ARK VALLEY CHIROPRACTIC
Entity Type:Organization
Organization Name:ARK VALLEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRILEA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-384-8039
Mailing Address - Street 1:12 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-2902
Mailing Address - Country:US
Mailing Address - Phone:719-384-8039
Mailing Address - Fax:719-384-2621
Practice Address - Street 1:12 E 10TH ST
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-2902
Practice Address - Country:US
Practice Address - Phone:719-384-8039
Practice Address - Fax:719-384-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty