Individual
MR. BRIAN C TANTILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1107 NEW POINTE BLVD SUITE B-6, CORE THERAPY SERVICES, LELAND, NC 28451-4217
(910) 399-1922
(866) 844-3505
Mailing address
1107 NEW POINTE BLVD SUITE B-6, CORE THERAPY SERVICES, LELAND, NC 28451-4217
(910) 399-1922
(866) 844-3505
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10015
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079NC
BCBSNC PROVIDER NUMBER
NC
Enumeration date
08/01/2006
Last updated
03/23/2017
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