Organization
CORNISH FAMILY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT CORNISH D.C. (CO-OWNER)
(641) 201-1028
Entity
Organization
Contact information
Practice address
1911 4TH ST SW, SUITE C, MASON CITY, IA 50401-4601
(641) 201-1028
(641) 201-1033
Mailing address
1911 4TH ST SW, SUITE C, MASON CITY, IA 50401-4601
(641) 201-1028
(641) 201-1033
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
007195
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548404007
—
IA
Enumeration date
08/03/2012
Last updated
08/03/2012
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