Healthcare Provider Details

I. General information

NPI: 1134200264
Provider Name (Legal Business Name): HEATHER MARIE KARY JARVIS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER MARIE KARY D.C.

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 LEWIS AVE S
WATERTOWN MN
55388-4535
US

IV. Provider business mailing address

PO BOX 39
WATERTOWN MN
55388-0039
US

V. Phone/Fax

Practice location:
  • Phone: 952-955-2070
  • Fax: 952-955-2370
Mailing address:
  • Phone: 952-955-2070
  • Fax: 952-955-2370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4378
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4378
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: