Provider Demographics
NPI:1700559036
Name:SACKETT, CORINNE L (DC)
Entity Type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:L
Last Name:SACKETT
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 1:1310 BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-4407
Mailing Address - Country:US
Mailing Address - Phone:717-633-9500
Mailing Address - Fax:717-633-5739
Practice Address - Street 1:1310 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-4407
Practice Address - Country:US
Practice Address - Phone:717-633-9500
Practice Address - Fax:717-633-5739
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006320L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor