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General NPI Number Information
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NPI Number | 1417469065
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Entity Type | Organization
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Legal Business Name | NEWCORE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 5111 ABERCORN ST
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City | SAVANNAH
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State | GA
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Zip | 31405-5214
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Country | US
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Telephone | 912-239-6140
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Fax | 912-335-3539
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Provider Business Mailing Address
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Address Line | PO BOX 15224
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City | SAVANNAH
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State | GA
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Zip | 31416-1924
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Country | US
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Telephone | 912-227-6962
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Fax | 912-330-1070
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Authorized Official
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Title or Position | CO-FOUNDER/CEO
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Name | MR. STUART M FIFE
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Credential | PT
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Telephone | 912-239-6140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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