Provider Demographics
NPI:1376712265
Name:CORSENTINO SPINAL
Entity Type:Organization
Organization Name:CORSENTINO SPINAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ROLAND
Authorized Official - Last Name:CORSENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-377-0051
Mailing Address - Street 1:801 DOWNTOWNER BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5403
Mailing Address - Country:US
Mailing Address - Phone:251-341-1211
Mailing Address - Fax:251-414-5104
Practice Address - Street 1:801 DOWNTOWNER BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5403
Practice Address - Country:US
Practice Address - Phone:251-341-1211
Practice Address - Fax:251-414-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4560864OtherAETNA
AL669113OtherUNITED HEALTH CARE
AL4560864OtherAETNA
ALK372Medicare PIN