Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4378 | MN |
N | 111NS0005X | Chiropractic Sports Physician | 4378 | MN |
NPI | 1134200264 |
---|---|
Provider Name | Dr. Heather Marie Kary Jarvis |
First Address | Watertown, MN 55388-0039 |
Second Address | Watertown, MN 55388-4535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 26/10/2021 |