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General NPI Number Information
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NPI Number | 1679767529
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Entity Type | Organization
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Legal Business Name | CORE THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 4874 BLAZER PKWY
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City | DUBLIN
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State | OH
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Zip | 43017-3302
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Country | US
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Telephone | 614-668-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 4874 BLAZER PKWY
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City | DUBLIN
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State | OH
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Zip | 43017-3302
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Country | US
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Telephone | 614-718-2673
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Fax | 614-718-2033
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Authorized Official
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Title or Position | CEO
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Name | MR. IAN RANDALL KIRK
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Credential | PT, OCS
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Telephone | 614-718-2673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | OH
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