Provider Demographics
NPI:1750561023
Name:CORNERSTONE CHIROPRACTIC CENTER INC.
Entity type:Organization
Organization Name:CORNERSTONE CHIROPRACTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-522-1223
Mailing Address - Street 1:1951 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1300
Mailing Address - Country:US
Mailing Address - Phone:740-522-1223
Mailing Address - Fax:740-522-1533
Practice Address - Street 1:1951 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1300
Practice Address - Country:US
Practice Address - Phone:740-522-1223
Practice Address - Fax:740-522-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9333751Medicare PIN