Provider Demographics
NPI:1770888182
Name:KING, COREY LEE (DC)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:LEE
Last Name:KING
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 1:1163 BLUE BELL RD
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-2723
Mailing Address - Country:US
Mailing Address - Phone:866-375-4641
Mailing Address - Fax:866-375-4641
Practice Address - Street 1:1163 BLUE BELL RD
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-2723
Practice Address - Country:US
Practice Address - Phone:866-375-4641
Practice Address - Fax:866-375-4641
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007909111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition