Provider Demographics
NPI:1336370014
Name:KORU HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:KORU HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WIMBERLY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, NTP
Authorized Official - Phone:541-434-1111
Mailing Address - Street 1:2775 FRIENDLY ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2254
Mailing Address - Country:US
Mailing Address - Phone:541-434-1111
Mailing Address - Fax:
Practice Address - Street 1:2775 FRIENDLY ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2254
Practice Address - Country:US
Practice Address - Phone:541-434-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty