Individual
TAMMY LYNN CARNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
704 FOUNTAIN MESA RD, FOUNTAIN, CO 80817-3160
(719) 233-2290
Mailing address
704 FOUNTAIN MESA RD, FOUNTAIN, CO 80817-3160
(719) 233-2290
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10777538
COLORADO SECRETARY OF STATE
CO
Enumeration date
11/02/2018
Last updated
11/02/2018
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