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General NPI Number Information
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NPI Number | 1982763744
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Entity Type | Organization
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Legal Business Name | CORE PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 301 MARGIE DR
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City | WARNER ROBINS
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State | GA
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Zip | 31088-7818
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Country | US
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Telephone | 478-953-5800
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Fax | 478-953-5855
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Provider Business Mailing Address
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Address Line | 301 MARGIE DR
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City | WARNER ROBINS
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State | GA
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Zip | 31088-7818
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Country | US
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Telephone | 478-953-5800
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Fax | 478-953-5855
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEITH BROWN
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Credential | P.T.
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Telephone | 478-953-5800
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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 | 005265
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License Number State | GA
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