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General NPI Number Information
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NPI Number | 1184422966
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Entity Type | Individual
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Provider Name | ISIAH CORBETT IV D.C
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Gender | Male
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 5429 CHESTNUT ST STE G19
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3325
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Country | US
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Telephone | 561-788-3630
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Fax |
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Provider Business Mailing Address
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Address Line | 13328 WESTHEIMER RD
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City | HOUSTON
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State | TX
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Zip | 77077-3593
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC012023
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License Number State | PA
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