Healthcare Provider Details

I. General information

NPI: 1457863169
Provider Name (Legal Business Name): COURTNEY HARRISON MAGDICI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 11/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 ATWOOD DR STE 2
RICHMOND KY
40475-8179
US

IV. Provider business mailing address

3488 GREENTREE RD
LEXINGTON KY
40517-3114
US

V. Phone/Fax

Practice location:
  • Phone: 859-623-2057
  • Fax:
Mailing address:
  • Phone: 270-993-1399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: