Provider Demographics
NPI:1659594059
Name:CORMIER CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:CORMIER CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:251-343-9990
Mailing Address - Street 1:6300 AIRPORT BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3158
Mailing Address - Country:US
Mailing Address - Phone:251-343-9990
Mailing Address - Fax:251-343-9181
Practice Address - Street 1:6300 AIRPORT BLVD STE C
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3158
Practice Address - Country:US
Practice Address - Phone:251-343-9990
Practice Address - Fax:251-343-9181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty