Provider Demographics
NPI:1972116176
Name:PELVICORE FOR LIVING LLC
Entity Type:Organization
Organization Name:PELVICORE FOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-506-4386
Mailing Address - Street 1:621 SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN UNIVERSITY
Mailing Address - State:PA
Mailing Address - Zip Code:19352-9021
Mailing Address - Country:US
Mailing Address - Phone:610-506-4386
Mailing Address - Fax:
Practice Address - Street 1:621 SAGINAW RD
Practice Address - Street 2:
Practice Address - City:LINCOLN UNIVERSITY
Practice Address - State:PA
Practice Address - Zip Code:19352-9021
Practice Address - Country:US
Practice Address - Phone:610-506-4386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty