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General NPI Number Information
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NPI Number | 1972005437
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Entity Type | Individual
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Provider Name | CORA BIESE DPT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 529 W SUMMIT AVE STE 1A
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City | CHARLOTTE
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State | NC
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Zip | 28203-4400
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Country | US
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Telephone | 704-228-3825
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 KNICKERBOCKER DR
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City | CHARLOTTE
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State | NC
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Zip | 28212-6732
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Country | US
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Telephone | 231-342-1046
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 5501018349
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | P22799
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License Number State | NC
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