Provider Demographics
NPI:1962652933
Name:DR. ALAN CORNFIELD NEW DESIGN CHIROPRACTIC AND REHABILITATION CENTERPA
Entity Type:Organization
Organization Name:DR. ALAN CORNFIELD NEW DESIGN CHIROPRACTIC AND REHABILITATION CENTERPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CORNFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-585-2225
Mailing Address - Street 1:7101 GUILFORD DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-5193
Mailing Address - Country:US
Mailing Address - Phone:301-631-5910
Mailing Address - Fax:301-631-5913
Practice Address - Street 1:7101 GUILFORD DR
Practice Address - Street 2:SUITE 105
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5193
Practice Address - Country:US
Practice Address - Phone:301-631-5910
Practice Address - Fax:301-631-5913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty