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NPI Code Detail

MEDICARE: DR. KRISTIN COURTNEY MASTERS PT, DPT, CLT-UE

MEDICARE: DR. KRISTIN COURTNEY MASTERS PT, DPT, CLT-UE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501016082MI

General Provider Information

NPI Number : 1043718372
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN COURTNEY MASTERS PT, DPT, CLT-UE
Provider Business Mailing Address
First Line : 240 KENSINGTON RD
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-4006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3394 E JOLLY RD STE B
Second Line :
City : LANSING
State : MI
Zip : 48910-8595
Country : US
Telephone Number : 517-975-3520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 02/01/2018

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