Provider Demographics
NPI:1245743210
Name:FURNEY, CARLY (DC)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:FURNEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14592 ALABAMA AVE S
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2830
Mailing Address - Country:US
Mailing Address - Phone:612-201-4474
Mailing Address - Fax:
Practice Address - Street 1:14148 LINCOLN ST NE
Practice Address - Street 2:
Practice Address - City:HAM LAKE
Practice Address - State:MN
Practice Address - Zip Code:55304-4651
Practice Address - Country:US
Practice Address - Phone:612-440-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor