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NPI Code Detail

MEDICARE: COURTNEY LYNN PT, DPT

MEDICARE: COURTNEY LYNN PT, DPT
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 TherapistPT017522GA

General Provider Information

NPI Number : 1619786282
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY LYNN PT, DPT
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3939 ATLANTA HWY STE 104
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-3761
Country : US
Telephone Number : 770-884-2800
Fax Number : 770-884-2805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2025
Last Update Date : 01/07/2025

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