Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT31578 | FL |
NPI | 1083136071 |
---|---|
Provider Name | Dr. Richard Joshua Courtney |
First Address | Orlando, FL 32804-1331 |
Second Address | Orlando, FL 32804-1331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2017 |
Last Update Date | 11/07/2017 |