Organization
CORA HEALTH SERVICES INC
Active
Other names
CORA Physical Therapy - Kennerly
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN KRZYMINSKI (EXECUTIVE VICE PRESIDENT)
(419) 221-6717
Entity
Organization
Contact information
Practice address
6100 KENNERLY RD STE 201, JACKSONVILLE, FL 32216-4379
(904) 739-9901
(904) 739-9903
Mailing address
PO BOX 150, LIMA, OH 45802-0150
(419) 221-6717
(419) 222-0507
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8841560-61
—
FL
01
—
RP5
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/14/2006
Last updated
09/28/2023
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