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General NPI Number Information
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NPI Number | 1699315994
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Entity Type | Organization
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Legal Business Name | CORNISH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 3350 CENTER GROVE DR
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City | DUBUQUE
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State | IA
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Zip | 52003-5200
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Country | US
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Telephone | 563-258-3229
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Fax |
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Provider Business Mailing Address
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Address Line | 2276 GRAHAM CIR
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City | DUBUQUE
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State | IA
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Zip | 52002-2717
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Country | US
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Telephone | 563-258-3229
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | CAROLYN CORNISH
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Credential |
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Telephone | 563-258-3229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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