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General NPI Number Information
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NPI Number | 1346162468
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Entity Type | Individual
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Provider Name | CORY WHITLOW PTA
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Gender | Male
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 221 SCHOOL ST
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-1078
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Country | US
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Telephone | 937-599-3688
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Fax | 937-599-1078
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Provider Business Mailing Address
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Address Line | 640 PARKLAND DR
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City | LAKEVIEW
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State | OH
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Zip | 43331-7500
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Country | US
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Telephone | 937-599-3688
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Fax | 937-599-1078
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 008581
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License Number State | OH
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