Cortney Lynn McCarthy, PTA

Individual provider Active NPI Physical Therapy Assistant · Grosse Ile, MI

NPI 1275970931 · NPPES record last updated Jun 4, 2013

Key facts

NPI
1275970931
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
5502000567 (MI)
Practice address
25143 Dallas Dr
Grosse Ile, MI 48138-1755
Phone
(734) 771-4847
NPI assigned
Jun 4, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5502000567MIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502000567 MI Yes

Addresses

Primary practice location

25143 Dallas Dr
Grosse Ile, MI 48138-1755

Mailing address

25143 Dallas Dr
Grosse Ile, MI 48138-1755

Other providers in Grosse Ile, MI

All providers in Grosse Ile, MI · Physical Therapy Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.