Provider Demographics
NPI:1861421976
Name:OSCARSON, COREY (DC)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:
Last Name:OSCARSON
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 1:1675 GREELEY ST S
Mailing Address - Street 2:#102
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6091
Mailing Address - Country:US
Mailing Address - Phone:651-430-2727
Mailing Address - Fax:
Practice Address - Street 1:1675 GREELEY ST S
Practice Address - Street 2:#102
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6091
Practice Address - Country:US
Practice Address - Phone:651-430-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor