MEDICARE: CORE SOLUTIONS PT INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1376024711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE SOLUTIONS PT INC

Provider Business Mailing Address
First Line	:	524 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-2221
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	524 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-2221
Country	:	US
Telephone Number	:	757-460-2522
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HEIDI SHETH
Credential	:
Telephone Number	:	757-460-2522

Provider Enumeration Date	:	08/23/2018
Last Update Date	:	03/13/2019

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Directions to “CORE SOLUTIONS PT INC ” Practice Location

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