Provider Demographics
NPI:1538119615
Name:CORBETT, TERRENCE PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:PETER
Last Name:CORBETT
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 1:455 S LIVERNOIS RD
Mailing Address - Street 2:STE: B-11
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2578
Mailing Address - Country:US
Mailing Address - Phone:248-652-4325
Mailing Address - Fax:248-652-4431
Practice Address - Street 1:455 S LIVERNOIS RD
Practice Address - Street 2:STE: B-11
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2578
Practice Address - Country:US
Practice Address - Phone:248-652-4325
Practice Address - Fax:248-652-4431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor