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General NPI Number Information
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NPI Number | 1861645947
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Entity Type | Organization
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Legal Business Name | CORNEILLER CHIROPRACTIC
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 2811 E HAMILTON AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6863
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Country | US
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Telephone | 715-831-8535
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Fax | 715-831-8535
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Provider Business Mailing Address
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Address Line | 2811 E HAMILTON AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701
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Country | US
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Telephone | 715-831-8535
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Fax | 715-831-8535
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JAMES JOSEPH CORNEILLER
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Credential | D.C.
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Telephone | 715-831-8535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 3871-012
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License Number State | WI
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