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General NPI Number Information
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NPI Number | 1265246508
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Entity Type | Individual
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Provider Name | CORINNE VUKASOVICH PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 5514 ATASCOCITA RD STE 160
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City | HUMBLE
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State | TX
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Zip | 77346-3761
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Country | US
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Telephone | 281-441-5371
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Fax |
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Provider Business Mailing Address
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Address Line | 310 W BROADWAY
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City | SUTTONS BAY
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State | MI
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Zip | 49682-9626
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Country | US
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Telephone | 703-593-3057
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Fax |
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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 | 1403895
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License Number State | TX
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