Provider Demographics
NPI:1467085670
Name:KOORS, FLORENCE E (NDTR)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:E
Last Name:KOORS
Suffix:
Gender:F
Credentials:NDTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 GROVE DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6223
Mailing Address - Country:US
Mailing Address - Phone:614-446-2704
Mailing Address - Fax:
Practice Address - Street 1:1189 GROVE DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6223
Practice Address - Country:US
Practice Address - Phone:614-446-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-16
Last Update Date:2020-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH965901