Individual
AVERY JOHN CARNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, OT/L
Contact information
Practice address
559 VINCENT ST., SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
(719) 723-6030
Mailing address
559 VINCENT ST., SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5071
NC
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
08/12/2025
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