Provider Demographics
NPI:1528370962
Name:POSTMA, KORI JEAN (PT)
Entity Type:Individual
Prefix:
First Name:KORI
Middle Name:JEAN
Last Name:POSTMA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1169
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1169
Mailing Address - Country:US
Mailing Address - Phone:724-465-3246
Mailing Address - Fax:
Practice Address - Street 1:212 STATE RT 94
Practice Address - Street 2:2F
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-3328
Practice Address - Country:US
Practice Address - Phone:973-209-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4OQA00927700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist