Organization
COMMUNITY CHIROPRACTIC CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE CORDOVA DC (OWNER DOCTOR)
(219) 836-2580
Entity
Organization
Contact information
Practice address
8000 CALUMET AVE, MUNSTER, IN 46321-1227
(219) 836-2580
(219) 836-9366
Mailing address
8000 CALUMET AVENUE, MUNSTER, IN 46321-1218
(219) 836-2580
(219) 836-9366
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001591A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100147700A
—
IN
Enumeration date
10/03/2006
Last updated
06/28/2017
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