Provider Demographics
NPI:1407085418
Name:CORE THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:CORE THERAPY SERVICES, INC.
Other - Org Name:CORE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:TANTILLA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:910-399-1922
Mailing Address - Street 1:1107 NEW POINTE BLVD
Mailing Address - Street 2:SUITE B-6
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-4127
Mailing Address - Country:US
Mailing Address - Phone:910-399-1922
Mailing Address - Fax:866-844-3505
Practice Address - Street 1:1107 NEW POINTE BLVD
Practice Address - Street 2:SUITE B-6
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-4127
Practice Address - Country:US
Practice Address - Phone:910-399-1922
Practice Address - Fax:866-844-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-11
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty