Provider Demographics
NPI:1174858450
Name:CORBIN, EMILY JEAN (LMT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
Last Name:CORBIN
Suffix:
Gender:F
Credentials:LMT
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 1833
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43301-1833
Mailing Address - Country:US
Mailing Address - Phone:740-387-1509
Mailing Address - Fax:
Practice Address - Street 1:1075 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4450
Practice Address - Country:US
Practice Address - Phone:740-387-1509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.012663-S225700000X
OH33.012663225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist