Provider Demographics
NPI:1538287412
Name:CORNIES, MATTHEW PHILIP (DC, HBSC, BS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PHILIP
Last Name:CORNIES
Suffix:
Gender:M
Credentials:DC, HBSC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8834 EATONWICK DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-4650
Mailing Address - Country:US
Mailing Address - Phone:901-937-9397
Mailing Address - Fax:
Practice Address - Street 1:3189 KIRBY WHITTEN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2854
Practice Address - Country:US
Practice Address - Phone:901-922-5398
Practice Address - Fax:901-922-5538
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor