Healthcare Provider Details

I. General information

NPI: 1982045605
Provider Name (Legal Business Name): CORE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 WHITE BLUFF RD STE 403
SAVANNAH GA
31406-4671
US

IV. Provider business mailing address

9100 WHITE BLUFF RD STE 403
SAVANNAH GA
31406-4671
US

V. Phone/Fax

Practice location:
  • Phone: 912-335-9747
  • Fax: 912-239-4389
Mailing address:
  • Phone: 912-335-9747
  • Fax: 912-239-4389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT006285
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CATHERINE LYNN NEAL
Title or Position: PT
Credential: PT
Phone: 912-596-4020