Organization
NEW WAVE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARISSA SUPRY DC (DC AND OWNER)
(303) 772-7337
Entity
Organization
Contact information
Practice address
829 MAIN ST STE 6, LONGMONT, CO 80501-4954
(303) 772-7337
(720) 378-6541
Mailing address
829 MAIN ST STE 6, LONGMONT, CO 80501-4954
(303) 772-7337
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
05/27/2020
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