Provider Demographics
NPI:1841333598
Name:CONN, CARY (DC)
Entity type:Individual
Prefix:
First Name:CARY
Middle Name:
Last Name:CONN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:CARY
Other - Middle Name:
Other - Last Name:CONN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:73768 DESERT DUNES DR
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-1820
Mailing Address - Country:US
Mailing Address - Phone:760-902-9943
Mailing Address - Fax:
Practice Address - Street 1:73350 EL PASEO STE 106
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4240
Practice Address - Country:US
Practice Address - Phone:760-346-5660
Practice Address - Fax:760-346-5640
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor