Provider Demographics
NPI:1952778193
Name:OBORNY, JARED M (DC)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:M
Last Name:OBORNY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:525 N NEVADA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1156
Mailing Address - Country:US
Mailing Address - Phone:719-505-4536
Mailing Address - Fax:719-634-4538
Practice Address - Street 1:525 N NEVADA AVE STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1156
Practice Address - Country:US
Practice Address - Phone:719-505-4536
Practice Address - Fax:719-634-4538
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor