Healthcare Provider Details
I. General information
NPI: 1396987426
Provider Name (Legal Business Name): CORNERSTONE CHIROPRACTIC & MASSAGE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2009
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4004 W ST JOE HWY
LANSING MI
48917-4215
US
IV. Provider business mailing address
4004 W ST JOE HWY
LANSING MI
48917-4215
US
V. Phone/Fax
- Phone: 517-327-7463
- Fax: 517-886-5238
- Phone: 517-327-7463
- Fax: 517-886-5238
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | BK007987 |
| License Number State | MI |
VIII. Authorized Official
Name:
BRIAN
KILLIAN
Title or Position: OWNER
Credential:
Phone: 517-927-9293