Provider Demographics
NPI:1396916839
Name:KIRK MCKEY DC PC
Entity type:Organization
Organization Name:KIRK MCKEY DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC PC
Authorized Official - Phone:970-824-4444
Mailing Address - Street 1:408 E VICTORY WAY
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-1826
Mailing Address - Country:US
Mailing Address - Phone:970-824-4444
Mailing Address - Fax:970-824-4448
Practice Address - Street 1:408 E VICTORY WAY
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-1826
Practice Address - Country:US
Practice Address - Phone:970-824-4444
Practice Address - Fax:970-824-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU96654Medicare UPIN
COC507198Medicare PIN