Healthcare Provider Details

I. General information

NPI: 1639083710
Provider Name (Legal Business Name): COURTNEY LEE SPOTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 TCHOUPITOULAS ST APT 11116
NEW ORLEANS LA
70130-1813
US

IV. Provider business mailing address

1485 TCHOUPITOULAS ST APT 11116
NEW ORLEANS LA
70130-1813
US

V. Phone/Fax

Practice location:
  • Phone: 504-877-6976
  • Fax:
Mailing address:
  • Phone: 504-877-6976
  • Fax: 504-877-6976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number010746879
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: