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Organization

CORNERSTONE CHIROPRACTIC OF HORTONVILLE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JARED SCOTT BEDOR DC (CO-OWNER)
(920) 850-2507
Entity
Organization

Contact information

Practice address
223 N PINE ST, HORTONVILLE, WI 54944-9140
(920) 850-2507
Mailing address
PO BOX 187, HORTONVILLE, WI 54944-0187

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5233-12
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100064521
WI
Enumeration date
02/20/2017
Last updated
05/07/2018
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