Provider Demographics
NPI:1235679598
Name:CORNERSTONE INTEGRATIVE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CORNERSTONE INTEGRATIVE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-365-9509
Mailing Address - Street 1:7227 E BASELINE RD
Mailing Address - Street 2:STE 106
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-5005
Mailing Address - Country:US
Mailing Address - Phone:480-832-5777
Mailing Address - Fax:480-584-4046
Practice Address - Street 1:1337 S GILBERT RD
Practice Address - Street 2:STE 105
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6073
Practice Address - Country:US
Practice Address - Phone:480-878-5480
Practice Address - Fax:480-584-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8053111N00000X
AZ7723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty