Provider Demographics
NPI:1417008160
Name:VANMETER, CORY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:
Last Name:VANMETER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 W BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:AR
Mailing Address - Zip Code:72855-4609
Mailing Address - Country:US
Mailing Address - Phone:479-965-6222
Mailing Address - Fax:
Practice Address - Street 1:4008 COLTON DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6350
Practice Address - Country:US
Practice Address - Phone:479-965-6222
Practice Address - Fax:479-452-6695
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist