Provider Demographics
NPI:1396291860
Name:MCKINNEY, COURTNEY (DC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MCKINNEY
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 1:1775 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1338
Mailing Address - Country:US
Mailing Address - Phone:707-445-8080
Mailing Address - Fax:707-445-8088
Practice Address - Street 1:655 F ST
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6325
Practice Address - Country:US
Practice Address - Phone:707-822-2224
Practice Address - Fax:707-822-2225
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC33662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor