Individual
MR. COREY L PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.O.
Contact information
Practice address
1028 LEE ANN DR NE, SUITE 50, CONCORD, NC 28025-2903
(704) 654-9279
Mailing address
1028 LEE ANN DR NE, SUITE 50, CONCORD, NC 28025-2903
(704) 654-9279
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Z00000X
Orthotist
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/12/2008
Last updated
06/28/2016
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