MEDICARE: CORE HEALTH

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	261QP2000X	Physical Therapy Clinic/Center
2	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1598516791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE HEALTH

Provider Business Mailing Address
First Line	:	1834 W NANCY CREEK DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-1453
Country	:	US
Telephone Number	:	404-585-1960
Fax Number	:

Provider Business Practice Location Address
First Line	:	2947 N DRUID HILLS RD NE STE C
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3980
Country	:	US
Telephone Number	:	404-585-1960
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	LISA OGONOWSKI HARLAN
Credential	:	DPT
Telephone Number	:	404-585-1960

Provider Enumeration Date	:	03/27/2024
Last Update Date	:	06/13/2024

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Directions to “CORE HEALTH ” Practice Location

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