MEDICARE: COURTNEY PERFORMANCE PHYSICAL THERAPY PLLC

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1609533165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COURTNEY PERFORMANCE PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	107 WOODMERE DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-5568
Country	:	US
Telephone Number	:	716-912-3756
Fax Number	:	716-322-3275

Provider Business Practice Location Address
First Line	:	4804 N FRENCH RD
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-2178
Country	:	US
Telephone Number	:	716-906-8877
Fax Number	:	716-322-3275

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	MR. ALEC COURTNEY
Credential	:	D.P.T.
Telephone Number	:	716-912-3756

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	04/28/2025

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