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General NPI Number Information
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NPI Number | 1942898093
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Entity Type | Organization
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Legal Business Name | COR WELLNESS INC.
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | W234N7303 FONTAINE CIR
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City | SUSSEX
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State | WI
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Zip | 53089-5714
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Country | US
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Telephone | 262-391-2837
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 286
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City | SUSSEX
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State | WI
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Zip | 53089-0286
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Country | US
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Telephone | 262-820-1759
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Fax |
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Authorized Official
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Title or Position | COO
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Name | ANDREW F CARLSON
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Credential |
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Telephone | 262-391-2837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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