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NPI Code Detail

MEDICARE: MR. CORY MICHAEL SEBERT PT

MEDICARE: MR. CORY MICHAEL SEBERT PT
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
1225100000XPhysical Therapist9543CO

General Provider Information

NPI Number : 1467614180
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CORY MICHAEL SEBERT PT
Provider Business Mailing Address
First Line : 307 E PLUM ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3328
Country : US
Telephone Number : 303-330-2595
Fax Number :
Provider Business Practice Location Address
First Line : 815 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1844
Country : US
Telephone Number : 303-330-2595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2008
Last Update Date : 04/18/2016

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