Provider Demographics
NPI:1376504431
Name:MCKINLEY, CORY ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:ALAN
Last Name:MCKINLEY
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 1:135 CROWN DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540
Mailing Address - Country:US
Mailing Address - Phone:434-799-5300
Mailing Address - Fax:434-799-4777
Practice Address - Street 1:135 CROWN DR
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540
Practice Address - Country:US
Practice Address - Phone:434-799-5300
Practice Address - Fax:434-799-4777
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555739111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010280231Medicaid
VA315356OtherSOUTHERN HEALTH
VA182102OtherANTHEM BCBS
VA9735557OtherCIGNA
VA010280231Medicaid
VA182102OtherANTHEM BCBS