Provider Demographics
NPI:1497973192
Name:CORFMAN, CHARLES GAROLD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:GAROLD
Last Name:CORFMAN
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 1:2530 FLORENCE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2808
Mailing Address - Country:US
Mailing Address - Phone:256-767-9900
Mailing Address - Fax:256-768-9905
Practice Address - Street 1:2530 FLORENCE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2808
Practice Address - Country:US
Practice Address - Phone:256-767-9900
Practice Address - Fax:256-768-9905
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU63211Medicare UPIN
AL000038595Medicare ID - Type Unspecified