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General NPI Number Information
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NPI Number | 1154217644
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Entity Type | Organization
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Legal Business Name | KORY MARSLAND CORPORATION
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 422 TAYLOR PLACE
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City | ITHACA
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State | NY
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Zip | 14850
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Country | US
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Telephone | 608-400-0141
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Fax | 608-561-8745
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Provider Business Mailing Address
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Address Line | 216 MYRTLE STREET W #146
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City | STILLWATER
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State | MN
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Zip | 55082
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Country | US
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Telephone | 608-400-0141
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Fax | 608-561-8745
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Authorized Official
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Title or Position | OWNER
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Name | PIERRE KORY
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Credential | MD
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Telephone | 608-400-0141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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