Healthcare Provider Details

I. General information

NPI: 1336961994
Provider Name (Legal Business Name): COR4
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50051 GOVERNORS DR STE E
CHAPEL HILL NC
27517-7018
US

IV. Provider business mailing address

202 KINSALE DR
CHAPEL HILL NC
27517-3433
US

V. Phone/Fax

Practice location:
  • Phone: 919-548-0659
  • Fax:
Mailing address:
  • Phone: 315-292-0526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. MEISCHE COX
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 907-580-1701