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Individual

COREY MILLWARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
108 FRANCISCAN WAY, LORETTO, PA 15940-9703
(814) 472-3936
Mailing address
792 GALLITZIN RD, CRESSON, PA 16630-2213
(814) 886-2955

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE010829
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346693736
PA
Enumeration date
07/20/2016
Last updated
03/22/2021
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