| Doctor Name: | MR. CORY WIRT |
| NPI Number: | 1215990122 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, MS PT, TPI-CGFI |
| License Number: | 2305202875 |
| Business Practice Address: | 6049 Harbour Park Drive Midlothian, VA - 23112 |
| Business Phone Number: | 8046392359 |
| Business Fax Number: | 8046392029 |
| Mailing Address: | 771 Pilot House Dr, Suite A NEWPORT NEWS |
| State: | VA |
| Postal Code: | 236061990 |
| Phone Number: | 7578732302 |
| Fax Number: | 7578732306 |
| NPI Enumeration Date: | 04/11/2006 |
| NPI Last Update Date: | 10/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305202875 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |