Individual
MR. CORNELIUS STALLWORTH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8686
Mailing address
445 N SAN JOAQUIN ST, STOCKTON, CA 95202-2003
(209) 943-4035
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
05/05/2008
Last updated
03/25/2025
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