Healthcare Provider Details

I. General information

NPI: 1801526652
Provider Name (Legal Business Name): COURTNEY LYNNE STANO DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33340 W 14 MILE RD
WEST BLOOMFIELD MI
48322-3572
US

IV. Provider business mailing address

4243 W BANCROFT ST APT 205W
OTTAWA HILLS OH
43615-3988
US

V. Phone/Fax

Practice location:
  • Phone: 248-538-7607
  • Fax: 248-538-7623
Mailing address:
  • Phone: 248-535-6639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501303313
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: