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General NPI Number Information
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NPI Number | 1346284874
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Entity Type | Individual
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Provider Name | COURTNEY JEAN HERR ATC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 500 OLD BARNSTABLE RD
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City | MASHPEE
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State | MA
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Zip | 02649-3130
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Country | US
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Telephone | 508-539-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 15 DANA LN
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City | EAST WAREHAM
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State | MA
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Zip | 02538-1248
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Country | US
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Telephone | 508-273-7119
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1471
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License Number State | MA
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