Provider Demographics
NPI:1851469167
Name:CORTESE, J.C. (DC)
Entity Type:Individual
Prefix:DR
First Name:J.C.
Middle Name:
Last Name:CORTESE
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 1:6090 RIVER JUNCTION RD SE
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:IA
Mailing Address - Zip Code:52755-9314
Mailing Address - Country:US
Mailing Address - Phone:319-629-5163
Mailing Address - Fax:
Practice Address - Street 1:6090 RIVER JUNCTION RD SE
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:IA
Practice Address - Zip Code:52755-9314
Practice Address - Country:US
Practice Address - Phone:319-629-5163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4705111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor