Healthcare Provider Details

I. General information

NPI: 1073443230
Provider Name (Legal Business Name): KORI COLLINS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 STONE RD
BELPRE OH
45714-2348
US

IV. Provider business mailing address

45959 SR-681
COOLVILLE OH
45723
US

V. Phone/Fax

Practice location:
  • Phone: 740-780-4040
  • Fax:
Mailing address:
  • Phone: 740-541-2815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.024617
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: