Courtney Mason
Individual provider Active NPI Physical Therapy Assistant · Renovo, PA
NPI 1114305703 · NPPES record last updated May 14, 2015
Key facts
- NPI
- 1114305703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- TEI004251 (PA)
- Practice address
- 1001 Pine St
Renovo, PA 17764-1618 - Phone
- (570) 923-1000
- Fax
- (570) 923-1812
- NPI assigned
- May 14, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TEI004251 | PA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TEI004251 | PA | Yes |
Addresses
Primary practice location
1001 Pine St
Renovo, PA 17764-1618
Mailing address
80 Mason Run Rd
Driftwood, PA 15832-4634
Other providers in Renovo, PA
- Frank L. Conly
- Quincey Sullivan George
- Rupert Johnson
- Amanda Mae Jones-Sutliff
- Toni Alice Marcheskie
- N Central PA Emergency Physicians, LLC
- PA Rte 120 Inpatient Services, LLC
- Phoenix Rural Home Health of PA
- Probst Family Practice, LLC
- Demetri Eugene Probst
All providers in Renovo, PA · Physical Therapy Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.