Healthcare Provider Details

I. General information

NPI: 1134133093
Provider Name (Legal Business Name): DAVID ANDREW CORD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WELLINGTON PL
CINCINNATI OH
45219-1758
US

IV. Provider business mailing address

111 WELLINGTON PL
CINCINNATI OH
45219-1758
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-0007
  • Fax: 513-241-4957
Mailing address:
  • Phone: 513-621-0007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3655
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: