Provider Demographics
NPI:1609664564
Name:KORRIGAN, NATHAN R (DC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:R
Last Name:KORRIGAN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 COVE PKWY STE 4
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-5567
Mailing Address - Country:US
Mailing Address - Phone:315-534-9659
Mailing Address - Fax:315-534-9659
Practice Address - Street 1:868 COVE PKWY STE 4
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-5567
Practice Address - Country:US
Practice Address - Phone:315-534-9659
Practice Address - Fax:315-534-9659
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor