Provider Demographics
NPI:1487752606
Name:CORTNER, MICHAEL W (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:CORTNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 WATERS ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-2832
Mailing Address - Country:US
Mailing Address - Phone:785-539-3975
Mailing Address - Fax:
Practice Address - Street 1:1109 WATERS ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-2832
Practice Address - Country:US
Practice Address - Phone:785-539-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS005474Medicare PIN