Provider Demographics
NPI:1285103978
Name:ATKINSON, CORA (DC)
Entity type:Individual
Prefix:
First Name:CORA
Middle Name:
Last Name:ATKINSON
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 1:2619 BLAIRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-5905
Mailing Address - Country:US
Mailing Address - Phone:850-656-2200
Mailing Address - Fax:
Practice Address - Street 1:2619 BLAIRSTONE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-5905
Practice Address - Country:US
Practice Address - Phone:850-656-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor