Provider Demographics
NPI:1295035814
Name:STICKNEY, CORY J (DC)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:J
Last Name:STICKNEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2417
Mailing Address - Country:US
Mailing Address - Phone:308-455-1500
Mailing Address - Fax:308-455-1502
Practice Address - Street 1:4715 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2417
Practice Address - Country:US
Practice Address - Phone:308-455-1500
Practice Address - Fax:308-455-1502
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor