Healthcare Provider Details

I. General information

NPI: 1881006724
Provider Name (Legal Business Name): COREY TODHUNTER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 COLUMBUS AVENUE
SAN FRANCISCO CA
94111
US

IV. Provider business mailing address

9 COLUMBUS AVENUE
SAN FRANCISCO CA
94111
US

V. Phone/Fax

Practice location:
  • Phone: 415-373-3897
  • Fax:
Mailing address:
  • Phone: 415-373-3897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: