Provider Demographics
NPI:1841537701
Name:CORNERSTONE CHIROPRACTIC & WELLNESS LLC
Entity type:Organization
Organization Name:CORNERSTONE CHIROPRACTIC & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STUBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-623-5481
Mailing Address - Street 1:153 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-2357
Mailing Address - Country:US
Mailing Address - Phone:715-201-1081
Mailing Address - Fax:715-627-0177
Practice Address - Street 1:153 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-2357
Practice Address - Country:US
Practice Address - Phone:715-201-1081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty