Individual
MRS. CHRISTY MARIE CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
N4175 CO RD KCA, BIG BAY, MI 49808
(906) 345-9314
(906) 345-9890
Mailing address
2150 S OAKDALE DR, BLOOMINGTON, IN 47403-3012
(812) 345-8485
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012942A
IN
225100000X
Physical Therapist
5501011331
MI
225100000X
Physical Therapist
9979-024
WI
Other
Enumeration date
06/09/2006
Last updated
08/02/2018
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