=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144688557
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CORNERSTONE THERAPIES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2016
-----------------------------------------------------
Last Update Date | 02/01/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 445 S GILPIN ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80209-2616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-999-8819
-----------------------------------------------------
Fax | 303-496-0208
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 460036
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80246-0036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-999-8819
-----------------------------------------------------
Fax | 303-496-0208
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CHERYL D MOCK
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 303-999-8819
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT.0000590
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------