Provider Demographics
NPI:1447030853
Name:CORNERSTONE CHIROPRACTIC OF ANTIGO LLC
Entity type:Organization
Organization Name:CORNERSTONE CHIROPRACTIC OF ANTIGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND COLLECTIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-623-5481
Mailing Address - Street 1:2006 PROGRESS BLVD
Mailing Address - Street 2:
Mailing Address - City:ANTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54409-2475
Mailing Address - Country:US
Mailing Address - Phone:715-623-5481
Mailing Address - Fax:715-627-0177
Practice Address - Street 1:2006 PROGRESS BLVD
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-2475
Practice Address - Country:US
Practice Address - Phone:715-623-5481
Practice Address - Fax:715-627-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty