Individual
MR. JOSE CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
8000 CALUMET AVE, MUNSTER, IN 46321-1227
(219) 836-2580
(219) 836-9366
Mailing address
8000 CALUMET AVE, MUNSTER, IN 46321-1227
(219) 836-2580
(219) 836-9366
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001591A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092523
ANTHEM
IN
01
—
90000866
BCBS IL
IL
Enumeration date
10/20/2006
Last updated
11/15/2007
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