Provider Demographics
NPI:1972165645
Name:KOR THERAPY, PLLC
Entity Type:Organization
Organization Name:KOR THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-791-5735
Mailing Address - Street 1:165 LORA MARTIN LN
Mailing Address - Street 2:
Mailing Address - City:MOUSIE
Mailing Address - State:KY
Mailing Address - Zip Code:41839-8935
Mailing Address - Country:US
Mailing Address - Phone:606-791-5735
Mailing Address - Fax:606-946-2238
Practice Address - Street 1:165 LORA MARTIN LN
Practice Address - Street 2:
Practice Address - City:MOUSIE
Practice Address - State:KY
Practice Address - Zip Code:41839-8935
Practice Address - Country:US
Practice Address - Phone:606-791-5735
Practice Address - Fax:606-946-2238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty