Individual
DR. CARISSA SUPRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
829 MAIN ST STE 6, LONGMONT, CO 80501-4954
(603) 848-1022
Mailing address
2409 TRIO FALLS DR, LOVELAND, CO 80538-7162
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHR.0008048
CO
Other
Enumeration date
07/10/2019
Last updated
01/23/2020
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