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NPI 1992167373

NPI 1992167373 : CORE PHYSICAL THERAPY & REHAB., P.C. : CHANTILLY, VA

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General NPI Number Information
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    NPI Number           |    1992167373
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    Entity Type          |    Organization 
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    Legal Business Name  |    CORE PHYSICAL THERAPY & REHAB., P.C. 
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Dates
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    Enumeration Date     |    03/24/2016
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    Last Update Date     |    05/01/2025
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Provider Practice Location Address
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    Address Line         |    14153 ROBERT PARIS CT STE A 
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    City                 |    CHANTILLY
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    State                |    VA
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    Zip                  |    20151-4225
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    Country              |    US
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    Telephone            |    703-865-6455
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    Fax                  |    703-649-6455
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Provider Business Mailing Address
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    Address Line         |    14153 ROBERT PARIS CT STE A 
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    City                 |    CHANTILLY
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    State                |    VA
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    Zip                  |    20151-4225
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    Country              |    US
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    Telephone            |    703-865-6455
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    Fax                  |    703-649-6455
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     BRIAN WOOGI KIM 
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    Credential           |    
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    Telephone            |    703-395-1305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QP2000X
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    Taxonomy Name        |    Physical Therapy Clinic/Center
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    License Number       |    2305208494
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    License Number State |    VA
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