Healthcare Provider Details

I. General information

NPI: 1740925593
Provider Name (Legal Business Name): COURTNEY COLYER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6116 E ARBOR AVE STE 106
MESA AZ
85206-6103
US

IV. Provider business mailing address

7350 E STETSON DR UNIT 1016W
SCOTTSDALE AZ
85251-3413
US

V. Phone/Fax

Practice location:
  • Phone: 925-667-5664
  • Fax:
Mailing address:
  • Phone: 208-292-8359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1359329
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT33114
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: