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General NPI Number Information
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NPI Number | 1063899540
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Entity Type | Individual
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Provider Name | JAMES P. CORCORAN DPT
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Gender | Male
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | NAVAJO ROUTE 4
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City | PINON
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State | AZ
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Zip | 86510
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Country | US
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Telephone | 928-725-3220
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Fax | 928-725-3613
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Provider Business Mailing Address
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Address Line | PO BOX PH
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City | CHINLE
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State | AZ
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Zip | 86503-8000
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Country | US
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Telephone | 928-674-7166
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Fax | 928-674-7705
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 23976
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License Number State | MD
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