Organization
CARLY KIRBY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY KIRBY DIPL. OF OM, LAC. (OWNER)
(720) 301-9705
Entity
Organization
Contact information
Practice address
1551 PROFESSIONAL LN UNIT 220, LONGMONT, CO 80501-6964
(303) 772-9660
(303) 772-9259
Mailing address
11720 MONTGOMERY CIR, LONGMONT, CO 80504-5209
(720) 301-9705
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1182
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265441885
PERSONAL NPI
CO
Enumeration date
11/27/2012
Last updated
11/27/2012
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