Provider Demographics
NPI:1467291526
Name:CORE CONNECTION PELVIC & ORTHOPEDIC PHYSICAL THERAPY
Entity type:Organization
Organization Name:CORE CONNECTION PELVIC & ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:DURIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:401-464-2122
Mailing Address - Street 1:707A CLAYTON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-4019
Mailing Address - Country:US
Mailing Address - Phone:401-464-2122
Mailing Address - Fax:628-867-2343
Practice Address - Street 1:707A CLAYTON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-4019
Practice Address - Country:US
Practice Address - Phone:401-464-2122
Practice Address - Fax:628-867-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty