Provider Demographics
NPI:1003355215
Name:CORON FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:CORON FAMILY CHIROPRACTIC PLLC
Other - Org Name:CORON FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CORON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-459-6505
Mailing Address - Street 1:856 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-5111
Mailing Address - Country:US
Mailing Address - Phone:507-459-6505
Mailing Address - Fax:
Practice Address - Street 1:856 W 5TH ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-5111
Practice Address - Country:US
Practice Address - Phone:507-459-6505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty