Provider Demographics
NPI:1265783369
Name:FOX, CORBIN CODY (DC)
Entity type:Individual
Prefix:DR
First Name:CORBIN
Middle Name:CODY
Last Name:FOX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:214 W WACKERLY ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2795
Mailing Address - Country:US
Mailing Address - Phone:989-837-5998
Mailing Address - Fax:989-835-9632
Practice Address - Street 1:214 W WACKERLY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2795
Practice Address - Country:US
Practice Address - Phone:989-837-5998
Practice Address - Fax:989-835-9632
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor