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Individual

DR. EDWARD D CORLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
4114 BRIDGEPORT WAY WEST, UNIVERSITY PLACE, WA 98466
(253) 564-8100
(253) 564-8387
Mailing address
4114 BRIDGEPORT WAY WEST, UNIVERSITY PLACE, WA 98466
(253) 564-8100
(253) 564-8387

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CH00003648
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO5411
REGENCE
WA
Enumeration date
12/19/2006
Last updated
02/01/2008
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