Organization
CORA SOUTH CAROLINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD C. ROUSH (EXECUTIVE VICE PRESIDENT)
(419) 221-6712
Entity
Organization
Contact information
Practice address
876 FORDING ISLAND RD STE 2, BLUFFTON, SC 29910-8677
(843) 507-8473
(843) 868-8043
Mailing address
1110 SHAWNEE RD, LIMA, OH 45805-3529
(419) 221-6720
(419) 222-0507
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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