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General NPI Number Information
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NPI Number | 1306539382
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Entity Type | Individual
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Provider Name | CORY PRINCE PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 2275 BEECH AVE
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City | BUENA VISTA
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State | VA
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Zip | 24416-3101
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Country | US
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Telephone | 540-466-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1311 MAMARONECK AVE STE 140
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City | WHITE PLAINS
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State | NY
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Zip | 10605-5224
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Country | US
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Telephone |
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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 | 2305215770
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License Number State | VA
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