Individual
COREY GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2040 N WILMOT RD, TUCSON, AZ 85712
(520) 300-6115
Mailing address
4293 BEAVER CREEK LANE, MEMPHIS, TN 38125
(901) 356-2852
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0000011512
TN
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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