Healthcare Provider Details

I. General information

NPI: 1952602294
Provider Name (Legal Business Name): COURTNEY M ATKINS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5234 STATE ROAD 54
NEW PORT RICHEY FL
34652-6049
US

IV. Provider business mailing address

3102 PALAMORE DR
HOLIDAY FL
34691-1131
US

V. Phone/Fax

Practice location:
  • Phone: 727-469-3069
  • Fax:
Mailing address:
  • Phone: 770-789-4074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA91115
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMT000465
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: