Provider Demographics
NPI:1912971110
Name:AIRHEART, CORY (MS, CGC)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:
Last Name:AIRHEART
Suffix:
Gender:M
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 BURLINGAME AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6814
Mailing Address - Country:US
Mailing Address - Phone:559-297-8909
Mailing Address - Fax:559-297-8909
Practice Address - Street 1:110 N VALERIA ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2167
Practice Address - Country:US
Practice Address - Phone:559-233-7700
Practice Address - Fax:559-233-7744
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS