Provider Demographics
NPI:1770005142
Name:CORBELLE, JUSTIN COLE (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:COLE
Last Name:CORBELLE
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 1:15 JEWEL LN
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-3136
Mailing Address - Country:US
Mailing Address - Phone:203-648-3065
Mailing Address - Fax:
Practice Address - Street 1:15 JEWEL LANE
Practice Address - Street 2:
Practice Address - City:NEW FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06812
Practice Address - Country:US
Practice Address - Phone:203-648-3065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor