Healthcare Provider Details

I. General information

NPI: 1689906208
Provider Name (Legal Business Name): MICHAEL RICHARD COURTRIGHT N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2010
Last Update Date: 02/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 KELA CRES
VIRGINIA BEACH VA
23451-6608
US

IV. Provider business mailing address

944 KELA CRES
VIRGINIA BEACH VA
23451-6608
US

V. Phone/Fax

Practice location:
  • Phone: 757-510-6864
  • Fax:
Mailing address:
  • Phone: 757-510-6864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: