Individual
DR. CHANTELL CRISAN COORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA02079300
NJ
225200000X
Physical Therapy Assistant
012585
NY
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
Update your record
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