| Organization Name: | CORA SOUTH CAROLINA LLC |
| NPI Number: | 1093123531 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRAD C ROUSH (EXECUTIVE VICE PRESIDENT) |
| Mailing Address: | 11931 Plaza Dr Murrells Inlet |
| State: | SC US |
| Postal Code: | 295769356 |
| Phone Number: | 8433574039 |
| Fax Number: | 8433574227 |
| NPI Enumeration Date: | 07/29/2014 |
| NPI Last Update Date: | 04/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |