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Individual
STACY E COREY
Active
Individual
STACY E COREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17932
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110100933A
MH
MA
Enumeration date
06/28/2007
Last updated
10/18/2017
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