Organization
COREPHYSIO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS RAOUL REEBERG P.T (MANAGING DIRECTOR)
(480) 507-0130
Entity
Organization
Contact information
Practice address
1017 S GILBERT RD, SUITE 104, MESA, AZ 85204-4442
(480) 507-0130
(480) 507-0135
Mailing address
1017 S GILBERT RD, SUITE 104, MESA, AZ 85204-4442
(480) 507-0130
(480) 507-0135
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6440
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114905254
NPI
AZ
Enumeration date
02/09/2010
Last updated
02/09/2010
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