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Individual
CORY JOSEPH BERKELEY
Active
Individual
CORY JOSEPH BERKELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT24419
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT244190
BLUE SHIELD
CA
01
—
650025479
RAILROAD MEDICARE
—
Enumeration date
12/01/2005
Last updated
09/03/2009
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