MEDICARE: DR. CAROLYN CORNISH DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	007258	IA

General Provider Information

NPI Number	:	1710295431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN CORNISH DC

Provider Business Mailing Address
First Line	:	2276 GRAHAM CIR
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52002-2717
Country	:	US
Telephone Number	:	563-258-3229
Fax Number	:

Provider Business Practice Location Address
First Line	:	2276 GRAHAM CIR
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52002-2717
Country	:	US
Telephone Number	:	563-258-3229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2010
Last Update Date	:	02/13/2017

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Directions to “ DR. CAROLYN CORNISH DC” Practice Location

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