Individual
DR. KIM P CORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6509 CENTRAL AVE, PORTAGE, IN 46368-3101
(219) 762-4801
(219) 764-9974
Mailing address
6509 CENTRAL AVE, PORTAGE, IN 46368-3101
(219) 762-4801
(219) 764-9974
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001658A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100207890
—
IN
Enumeration date
02/23/2006
Last updated
06/11/2008
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