Provider Demographics
NPI:1952626459
Name:HAMPTON, CORIE
Entity type:Individual
Prefix:
First Name:CORIE
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 WALKER AVE
Mailing Address - Street 2:136 HHP BUILDING
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-5020
Mailing Address - Country:US
Mailing Address - Phone:336-334-5925
Mailing Address - Fax:336-256-0407
Practice Address - Street 1:1408 WALKER AVE
Practice Address - Street 2:136 HHP BUILDING
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-5020
Practice Address - Country:US
Practice Address - Phone:336-334-5925
Practice Address - Fax:336-256-0407
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer