Provider Demographics
NPI:1881430395
Name:HAHN, COREY (PTA)
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:
Last Name:HAHN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4399 REDTAIL DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2356
Mailing Address - Country:US
Mailing Address - Phone:443-690-5571
Mailing Address - Fax:
Practice Address - Street 1:116 WESTMINSTER PIKE STE 100
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-1056
Practice Address - Country:US
Practice Address - Phone:410-833-9300
Practice Address - Fax:855-485-4166
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4408225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant