Provider Demographics
NPI:1285042952
Name:KOREN, ALAN JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:KOREN
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-1038
Mailing Address - Country:US
Mailing Address - Phone:330-565-2335
Mailing Address - Fax:
Practice Address - Street 1:670 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-1038
Practice Address - Country:US
Practice Address - Phone:330-565-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer