Individual
COREY JACOB FORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4460 S NOLAND RD, INDEPENDENCE, MO 64055-4743
(816) 373-2845
(816) 373-2842
Mailing address
2516 W 89TH ST, LEAWOOD, KS 66206-1609
(913) 381-8317
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-02932
KS
225100000X
Physical Therapist
Primary
2000172896
MO
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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