Most Relevant Information
Provider Data
| NPI Number: | 1003297995 |
| Provider Name: | CORY GENTILE MS, LAT, ATC, PES |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/16/2015 |
| Last Updated: | 06/07/2016 |
Provider Practice Location
830 JESSUP ST
DUNMORE
PA
185122145
Practice Location Phone/Fax
| Phone: | 5708770258 |
| Fax: |
Provider Mailing Location
830 JESSUP ST
DUNMORE
PA
185122145
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |