Provider Demographics
NPI:1710325469
Name:CORE REHABILITATION INC.
Entity Type:Organization
Organization Name:CORE REHABILITATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:KOLOC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:863-678-7005
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33859-0111
Mailing Address - Country:US
Mailing Address - Phone:863-678-0705
Mailing Address - Fax:863-678-0700
Practice Address - Street 1:2031 STATE ROAD 60 E
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33898-5113
Practice Address - Country:US
Practice Address - Phone:863-678-0705
Practice Address - Fax:863-678-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty