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General NPI Number Information
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NPI Number | 1295085819
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Entity Type | Organization
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Legal Business Name | CORON PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 242 W LANDIS AVE
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City | VINELAND
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State | NJ
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Zip | 08360-8109
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Country | US
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Telephone | 609-417-2652
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Fax |
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Provider Business Mailing Address
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Address Line | 98 HINCHMAN RD
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City | MEDFORD
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State | NJ
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Zip | 08055-8168
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Country | US
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Telephone | 609-417-2652
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Fax |
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Authorized Official
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Title or Position | PT
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Name | MR. CORTNEY HASSLER
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Credential |
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Telephone | 609-417-2652
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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 |
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License Number State |
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