Provider Demographics
NPI:1154217644
Name:KORY MARSLAND CORPORATION
Entity type:Organization
Organization Name:KORY MARSLAND CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:
Authorized Official - Last Name:KORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-400-0141
Mailing Address - Street 1:216 MYRTLE STREET W
Mailing Address - Street 2:#146
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082
Mailing Address - Country:US
Mailing Address - Phone:608-400-0141
Mailing Address - Fax:608-561-8745
Practice Address - Street 1:422 TAYLOR PLACE
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:608-400-0141
Practice Address - Fax:608-561-8745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty