MEDICARE: COREY JOSEPH LUMP DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		OH

General Provider Information

NPI Number	:	1902489438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY JOSEPH LUMP DPT

Provider Business Mailing Address
First Line	:	382 FRANKLIN CIR
Second Line	:
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-8248
Country	:	US
Telephone Number	:	740-637-0092
Fax Number	:

Provider Business Practice Location Address
First Line	:	9240 DUBLIN RD
Second Line	:
City	:	POWELL
State	:	OH
Zip	:	43065-9643
Country	:	US
Telephone Number	:	614-379-1120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	05/03/2021

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