Provider Demographics
NPI:1134304892
Name:CORY, LINDA LUANNE (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LUANNE
Last Name:CORY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3423
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86340-3423
Mailing Address - Country:US
Mailing Address - Phone:928-204-2924
Mailing Address - Fax:928-282-0072
Practice Address - Street 1:2515 W HWY 89A
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5254
Practice Address - Country:US
Practice Address - Phone:928-204-2924
Practice Address - Fax:928-282-0072
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist