Provider Demographics
NPI:1679767529
Name:CORE THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:CORE THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS
Authorized Official - Phone:614-718-2673
Mailing Address - Street 1:4874 BLAZER PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3302
Mailing Address - Country:US
Mailing Address - Phone:614-718-2673
Mailing Address - Fax:614-718-2033
Practice Address - Street 1:4874 BLAZER PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3302
Practice Address - Country:US
Practice Address - Phone:614-668-7288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy