Individual
MICHAEL CORCORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8148 MORO ST, PHILADELPHIA, PA 19136-2620
(215) 680-8645
Mailing address
8148 MORO ST, PHILADELPHIA, PA 19136-2620
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE1003297
PA
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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