Provider Demographics
NPI:1548976103
Name:COR PHYSICAL THERAPY AND PILATES STUDIO LLC
Entity type:Organization
Organization Name:COR PHYSICAL THERAPY AND PILATES STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABERNATHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-414-0991
Mailing Address - Street 1:2709 BUTLER PL
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-3710
Mailing Address - Country:US
Mailing Address - Phone:706-414-0991
Mailing Address - Fax:
Practice Address - Street 1:3604 VERANDAH DR STE AANDB
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-5608
Practice Address - Country:US
Practice Address - Phone:706-250-0081
Practice Address - Fax:762-320-5338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Multi-Specialty