Provider Demographics
NPI:1639506256
Name:CORNING, CHARITY ANN (DVM)
Entity Type:Individual
Prefix:DR
First Name:CHARITY
Middle Name:ANN
Last Name:CORNING
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 S JOE MARTINEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-3555
Mailing Address - Country:US
Mailing Address - Phone:719-547-4494
Mailing Address - Fax:719-657-1320
Practice Address - Street 1:472 S JOE MARTINEZ BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-3555
Practice Address - Country:US
Practice Address - Phone:719-547-4494
Practice Address - Fax:719-657-1320
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9117174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian