Provider Demographics
NPI:1326659889
Name:CORBACIO, CIANNA ELIZABETH (DPT)
Entity Type:Individual
Prefix:
First Name:CIANNA
Middle Name:ELIZABETH
Last Name:CORBACIO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 N CLAUDE A LORD BLVD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2705
Mailing Address - Country:US
Mailing Address - Phone:570-516-9858
Mailing Address - Fax:570-581-8022
Practice Address - Street 1:495 N CLAUDE A LORD BLVD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2705
Practice Address - Country:US
Practice Address - Phone:570-516-9858
Practice Address - Fax:570-581-8022
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028645225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist