P.U.R.E. Golf

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.010664 Issued in IL

Legal business name

P.U.R.E. GOLF

Practice address

1727 Deer Run Dr
Montgomery, IL 60538-3000

Phone

(630) 362-5172

NPI assigned

Aug 23, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Corey Puyear, PT

Title

President

Phone

(630) 362-5172

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250985600000",
    "number": "1710119821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 DEER RUN DR",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605383000",
            "telephone_number": "630-362-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 DEER RUN DR",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605383000",
            "telephone_number": "630-362-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.U.R.E. GOLF",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-23",
        "last_updated": "2009-08-23",
        "status": "A",
        "authorized_official_last_name": "PUYEAR",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-362-5172",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.010664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Montgomery, IL
• Providers in Montgomery, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.