Most Relevant Information
Provider Data
| NPI Number: | 1003481235 |
| Provider Name: | CORY RAISOR |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 2156885 |
Most Important Dates
| Enumeration Date: | 05/20/2021 |
| Last Updated: | 05/20/2021 |
Provider Practice Location
701 SUNSET HILLS DR
MACON
MO
635522165
Practice Location Phone/Fax
| Phone: | 6603853113 |
| Fax: |
Provider Mailing Location
703 W LEE ST
DIMMITT
TX
790273117
Provider Mailing Phone/Fax
| Phone: | 4357490050 |
| Fax: |