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General NPI Number Information
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NPI Number | 1376016576
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Entity Type | Organization
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Legal Business Name | CORNERSTONE FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 6 W MAIN ST
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City | MARCELLUS
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State | NY
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Zip | 13108-1118
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Country | US
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Telephone | 315-288-3633
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Fax | 315-748-5372
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Provider Business Mailing Address
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Address Line | 6 W MAIN ST
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City | MARCELLUS
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State | NY
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Zip | 13108-1118
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Country | US
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Telephone | 315-288-3633
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Fax | 315-748-5372
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Authorized Official
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Title or Position | SOLE MEMBER / OWNER
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Name | DR. MICHELLE C GOLDYCH
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Credential | DC
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Telephone | 315-288-3633
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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 |
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License Number State |
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