Provider Demographics
NPI:1811220064
Name:HARDY, COLIN EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:EUGENE
Last Name:HARDY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 E GRINNELL PLZ
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-3936
Mailing Address - Country:US
Mailing Address - Phone:307-672-6000
Mailing Address - Fax:
Practice Address - Street 1:24 E GRINNELL PLZ
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-3936
Practice Address - Country:US
Practice Address - Phone:307-672-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor