Provider Demographics
NPI:1912047655
Name:CORDER, MICHAEL CRAIG (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CRAIG
Last Name:CORDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1553 S NOVATO BLVD
Mailing Address - Street 2:A2 CORDER CHIROPRACTIC OFFICE
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947
Mailing Address - Country:US
Mailing Address - Phone:415-892-9438
Mailing Address - Fax:415-892-9438
Practice Address - Street 1:1553 S NOVATO BLVD
Practice Address - Street 2:A2 CORDER CHIROPRACTIC OFFICE
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947
Practice Address - Country:US
Practice Address - Phone:415-892-9438
Practice Address - Fax:415-892-9438
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor