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General NPI Number Information
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NPI Number | 1679059000
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Entity Type | Individual
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Provider Name | COURTNEY JEAN RAYFIELD MS, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 1301 20TH ST S
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City | GREAT FALLS
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State | MT
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Zip | 59405-4934
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Country | US
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Telephone | 406-791-5938
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 29TH ST S APT 104
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City | GREAT FALLS
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State | MT
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Zip | 59405-5352
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Country | US
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Telephone | 406-207-3551
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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 | ATR-LAT-LIC-714
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License Number State | MT
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