Provider Demographics
NPI:1447096896
Name:CORTELLONI, KATELYN ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:ANNE
Last Name:CORTELLONI
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 1:3300 PRINCESS ANNE RD STE 735
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-2604
Mailing Address - Country:US
Mailing Address - Phone:757-321-7776
Mailing Address - Fax:
Practice Address - Street 1:3300 PRINCESS ANNE RD STE 735
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-2604
Practice Address - Country:US
Practice Address - Phone:757-321-7776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557996111N00000X
GACHIR011212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor