Provider Demographics
NPI:1922162411
Name:ECKARD, KEVIN D (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:D
Last Name:ECKARD
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:PO BOX 2260
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-2260
Mailing Address - Country:US
Mailing Address - Phone:970-331-9679
Mailing Address - Fax:
Practice Address - Street 1:150 E BEAVER CREEK BLVD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620-5414
Practice Address - Country:US
Practice Address - Phone:970-331-9679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor