Provider Demographics
NPI:1700869013
Name:CORSIGLIA, JAMES ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:CORSIGLIA
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 1:2020 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-3961
Mailing Address - Country:US
Mailing Address - Phone:563-322-1110
Mailing Address - Fax:563-322-0017
Practice Address - Street 1:2020 E 11TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-3961
Practice Address - Country:US
Practice Address - Phone:563-322-1110
Practice Address - Fax:563-322-0017
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA26949OtherBCBS PPO
IA26949OtherBCBS PPO
I12571Medicare UPIN