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NPI Code Detail

MEDICARE: COREY LANGERUD

MEDICARE: COREY LANGERUD
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 Therapist13126AZ

General Provider Information

NPI Number : 1649793860
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY LANGERUD
Provider Business Mailing Address
First Line : 5040 N 15TH AVE STE 401
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-3332
Country : US
Telephone Number : 602-285-0949
Fax Number :
Provider Business Practice Location Address
First Line : 5040 N 15TH AVE STE 401
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-3332
Country : US
Telephone Number : 602-285-0949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2017
Last Update Date : 07/21/2017

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Directions to “ COREY LANGERUD ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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