Provider Demographics
NPI:1972005494
Name:CORDELL, TERESA M (DC)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:M
Last Name:CORDELL
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:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:KS
Mailing Address - Zip Code:67554-0235
Mailing Address - Country:US
Mailing Address - Phone:620-509-7977
Mailing Address - Fax:620-904-0639
Practice Address - Street 1:108 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:KS
Practice Address - Zip Code:67554-2718
Practice Address - Country:US
Practice Address - Phone:620-509-7977
Practice Address - Fax:620-904-0639
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor