Cory Disbennett, PT, DPT, ATC
Individual provider Active NPI Physical Therapist · Eaton, OH
NPI 1326563255 · NPPES record last updated Aug 11, 2017
Key facts
- NPI
- 1326563255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT016977 (OH)
- Practice address
- 450B Washington Jackson Rd Ste 110
Eaton, OH 45320-7601 - Phone
- (513) 502-3132
- NPI assigned
- Aug 11, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016977 | OH | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016977 | OH | Yes |
Addresses
Primary practice location
450B Washington Jackson Rd Ste 110
Eaton, OH 45320-7601
Mailing address
1000 Painter Fork Dr
Bethel, OH 45106-7811
Phone (513) 876-7230
Other providers in Eaton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.