Provider Demographics
NPI:1316728454
Name:BISCHOFF, KORYNN
Entity type:Individual
Prefix:
First Name:KORYNN
Middle Name:
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 W BRUCE DR
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1607
Mailing Address - Country:US
Mailing Address - Phone:215-460-7049
Mailing Address - Fax:
Practice Address - Street 1:3241 W BRUCE DR
Practice Address - Street 2:
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025-1607
Practice Address - Country:US
Practice Address - Phone:215-460-7049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer