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General NPI Number Information
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NPI Number | 1710029004
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Entity Type | Individual
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Provider Name | CORY PUYEAR PT
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 780 BURR OAK DR
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City | WESTMONT
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State | IL
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Zip | 60559-1122
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Country | US
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Telephone | 630-323-2225
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Fax | 630-323-7790
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Provider Business Mailing Address
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Address Line | 780 BURR OAK DR
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City | WESTMONT
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State | IL
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Zip | 60559-1122
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Country | US
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Telephone | 630-323-2225
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Fax | 630-323-7790
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070010664
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License Number State | IL
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