Provider Demographics
NPI:1356092266
Name:CORNERSTONE FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-744-0857
Mailing Address - Street 1:2670 E COUNTY LINE RD UNIT K
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-3234
Mailing Address - Country:US
Mailing Address - Phone:720-583-4506
Mailing Address - Fax:720-458-0439
Practice Address - Street 1:2670 E COUNTY LINE RD UNIT K
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-3234
Practice Address - Country:US
Practice Address - Phone:720-583-4506
Practice Address - Fax:720-458-0439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty