Provider Demographics
NPI:1326344839
Name:WONDERLY, CORY G (DC)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:G
Last Name:WONDERLY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 HIGH TOWER BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-1134
Mailing Address - Country:US
Mailing Address - Phone:412-275-3034
Mailing Address - Fax:412-275-3037
Practice Address - Street 1:100 HIGH TOWER BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1134
Practice Address - Country:US
Practice Address - Phone:412-275-3034
Practice Address - Fax:412-275-3037
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASTUDENT111NI0900X
PADC010528111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist