Provider Demographics
NPI:1164613980
Name:CORNERSTONE CHIROPRACTIC CLINIC PS
Entity Type:Organization
Organization Name:CORNERSTONE CHIROPRACTIC CLINIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:CLIFTON
Authorized Official - Last Name:WHITEMARSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-942-1212
Mailing Address - Street 1:1903 GEORGE WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2307
Mailing Address - Country:US
Mailing Address - Phone:509-942-1212
Mailing Address - Fax:509-942-9155
Practice Address - Street 1:1903 GEORGE WASHINGTON WAY
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2307
Practice Address - Country:US
Practice Address - Phone:509-942-1212
Practice Address - Fax:509-942-9155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty