Provider Demographics
NPI:1437302460
Name:CORNERSTONE CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:CORNERSTONE CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:814-938-3111
Mailing Address - Street 1:115 W MAHONING ST
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2016
Mailing Address - Country:US
Mailing Address - Phone:814-938-3111
Mailing Address - Fax:814-618-1037
Practice Address - Street 1:115 W MAHONING ST
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2016
Practice Address - Country:US
Practice Address - Phone:814-938-3111
Practice Address - Fax:814-618-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009368261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087652Medicare UPIN