Provider Demographics
NPI:1063843662
Name:KORB, ROBERT
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:KORB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:
Other - Last Name:KORB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:501 VALLEYBROOK ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3428
Mailing Address - Country:US
Mailing Address - Phone:724-941-6895
Mailing Address - Fax:412-731-4836
Practice Address - Street 1:501 VALLEYBROOK RD
Practice Address - Street 2:SUITE 206
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3428
Practice Address - Country:US
Practice Address - Phone:724-941-6895
Practice Address - Fax:412-731-4836
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG 000587175F00000X
SC1985175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath