Provider Demographics
NPI:1790075745
Name:CORUM, JAMES T JR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:T
Last Name:CORUM
Suffix:JR
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:PO BOX 824
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-0824
Mailing Address - Country:US
Mailing Address - Phone:606-248-1996
Mailing Address - Fax:606-248-1901
Practice Address - Street 1:1847 N 25TH ST
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1853
Practice Address - Country:US
Practice Address - Phone:606-248-1996
Practice Address - Fax:606-248-1901
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY005704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist