Provider Demographics
NPI:1538932710
Name:GARLICK, CALLIE JORDAN (DC)
Entity type:Individual
Prefix:DR
First Name:CALLIE
Middle Name:JORDAN
Last Name:GARLICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30880 COUNTY ROAD 356-6
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-8616
Mailing Address - Country:US
Mailing Address - Phone:724-562-0683
Mailing Address - Fax:
Practice Address - Street 1:211 TABOR ST
Practice Address - Street 2:104
Practice Address - City:BUENA VISTA
Practice Address - State:CO
Practice Address - Zip Code:81211
Practice Address - Country:US
Practice Address - Phone:719-204-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor