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General NPI Number Information
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NPI Number | 1497093058
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Entity Type | Organization
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Legal Business Name | CORE PHYSICAL THERAPY & PILATES LLC
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 616 MAIN ST
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-1595
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Country | US
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Telephone | 269-429-5447
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Fax |
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Provider Business Mailing Address
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Address Line | 616 MAIN ST
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-1595
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Country | US
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Telephone | 269-429-5447
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER/SOLE MEMBER
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Name | JANEL BENORE
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Credential | MPT
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Telephone | 269-429-5447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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