Individual
MR. CORY WILLIAM HUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T., ATC, MBA
Contact information
Practice address
7210 VILLAGE MEDICAL CIR STE 115, CLEMMONS, NC 27012-8045
(336) 893-2460
(336) 893-2468
Mailing address
PO BOX 601791, CHARLOTTE, NC 28260-1791
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
7697
TN
225100000X
Physical Therapist
8045
NC
225100000X
Physical Therapist
Primary
P8045
NC
Other
Enumeration date
07/07/2006
Last updated
07/30/2024
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