MEDICARE: CORI A MISNER P.T., D.P.T

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	225100000X	Physical Therapist	30113	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30113	OTHER	AZ	BOARD OF PHYSICAL THERAPY

General Provider Information

NPI Number	:	1982183307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORI A MISNER P.T., D.P.T

Provider Business Mailing Address
First Line	:	1930 E SOUTHERN AVE
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7518
Country	:	US
Telephone Number	:	480-456-0719
Fax Number	:	480-456-0163

Provider Business Practice Location Address
First Line	:	1219 E GLENDALE AVE STE 19
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-5430
Country	:	US
Telephone Number	:	602-837-0957
Fax Number	:	602-592-8662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	01/21/2026

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Directions to “ CORI A MISNER P.T., D.P.T” Practice Location

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