Provider Demographics
NPI:1295085819
Name:CORON PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:CORON PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:MR
Authorized Official - First Name:CORTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-417-2652
Mailing Address - Street 1:98 HINCHMAN RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8168
Mailing Address - Country:US
Mailing Address - Phone:609-417-2652
Mailing Address - Fax:
Practice Address - Street 1:242 W LANDIS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8109
Practice Address - Country:US
Practice Address - Phone:609-417-2652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty