Provider Demographics
NPI:1861406050
Name:CORKINS, H. GLENN (DC, PHD, NMD)
Entity type:Individual
Prefix:DR
First Name:H.
Middle Name:GLENN
Last Name:CORKINS
Suffix:
Gender:M
Credentials:DC, PHD, NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 542587
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33454-2587
Mailing Address - Country:US
Mailing Address - Phone:561-807-7763
Mailing Address - Fax:561-433-1284
Practice Address - Street 1:6637 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3354
Practice Address - Country:US
Practice Address - Phone:561-433-4184
Practice Address - Fax:561-433-1284
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7829111N00000X, 111NN1001X, 111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0200XChiropractic ProvidersChiropractorRadiology