Provider Demographics
NPI:1639773278
Name:KORNIK, CORA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:CORA
Middle Name:LEE
Last Name:KORNIK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 21ST ST SE APT 210
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-6343
Mailing Address - Country:US
Mailing Address - Phone:204-572-5924
Mailing Address - Fax:
Practice Address - Street 1:2008 TWIN CITY DR
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-3820
Practice Address - Country:US
Practice Address - Phone:701-204-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor