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General NPI Number Information
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NPI Number | 1356801104
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Entity Type | Organization
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Legal Business Name | CORA HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 465 TOWN PLAZA AVE STE B
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32081-5164
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Country | US
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Telephone | 42-223-7809
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Fax | 904-306-5772
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Provider Business Mailing Address
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Address Line | PO BOX 150
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City | LIMA
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State | OH
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Zip | 45802-0150
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Country | US
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Telephone | 419-221-6717
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Fax | 419-222-0507
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Authorized Official
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Title or Position | EXEC VP
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Name | STEVE KRZYMINSKI
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Credential |
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Telephone | 419-221-6717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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