Provider Demographics
NPI:1427014356
Name:YELLEN, CORNELL MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:CORNELL
Middle Name:MICHAEL
Last Name:YELLEN
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 1:256 MALL BLVD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2902
Mailing Address - Country:US
Mailing Address - Phone:610-265-1124
Mailing Address - Fax:610-265-1134
Practice Address - Street 1:256 MALL BLVD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2902
Practice Address - Country:US
Practice Address - Phone:610-265-1124
Practice Address - Fax:610-265-1134
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006347L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor