# CARLY KIRBY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578807889
- **Authorized official:** CARLY KIRBY DIPL. OF OM, LAC. (OWNER)
- **Authorized official phone:** (720) 301-9705

## Contact information

- **Practice address:** 1551 PROFESSIONAL LN UNIT 220, LONGMONT, CO 80501-6964
- **Practice address phone:** (303) 772-9660
- **Practice address fax:** (303) 772-9259
- **Mailing address:** 11720 MONTGOMERY CIR, LONGMONT, CO 80504-5209
- **Mailing address phone:** (720) 301-9705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 1182 | CO | Yes |

## Other

- **Enumeration date:** 11/27/2012
- **Last updated:** 11/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1265441885 | PERSONAL NPI | CO |