Provider Demographics
NPI:1629239207
Name:CORE HEALTH
Entity Type:Organization
Organization Name:CORE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:WOODARD
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:703-283-3311
Mailing Address - Street 1:19309 WINMEADE DR
Mailing Address - Street 2:NUMBER 111
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6507
Mailing Address - Country:US
Mailing Address - Phone:703-283-3311
Mailing Address - Fax:
Practice Address - Street 1:20098 ASHBROOK PL
Practice Address - Street 2:SUITE 190
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3393
Practice Address - Country:US
Practice Address - Phone:703-283-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty