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General NPI Number Information
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NPI Number | 1508502329
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Entity Type | Individual
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Provider Name | CORY STOCKER DPT
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Gender | Male
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 500 MEDICAL PARK DR
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City | DOVER
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State | OH
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Zip | 44622-3204
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Country | US
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Telephone | 330-602-0719
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Fax |
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Provider Business Mailing Address
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Address Line | 3157 CLOVERHURST ST NE
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City | CANTON
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State | OH
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Zip | 44721-2780
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT-014906
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License Number State | OH
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