Provider Demographics
NPI:1255899779
Name:CORE HEALTH LLC
Entity type:Organization
Organization Name:CORE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:571-510-5968
Mailing Address - Street 1:20098 ASHBROOK PL STE 190
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3394
Mailing Address - Country:US
Mailing Address - Phone:703-615-8827
Mailing Address - Fax:571-386-1559
Practice Address - Street 1:20098 ASHBROOK PL STE 190
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3394
Practice Address - Country:US
Practice Address - Phone:571-510-5968
Practice Address - Fax:571-386-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty