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General NPI Number Information
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NPI Number | 1821175357
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Entity Type | Individual
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Provider Name | ZACHARY LANE CORIELL PT
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 8520 OHIO RIVER RD
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City | WHEELERSBURG
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State | OH
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Zip | 45694-1874
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Country | US
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Telephone | 740-981-7758
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 CORIELL RD
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City | PORTSMOUTH
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State | OH
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Zip | 45662-9085
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Country | US
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Telephone | 740-981-7758
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13509
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT13509
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License Number State | OH
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