Courtney Leann Carothers, PTA
Individual provider Active NPI Physical Therapy Assistant · Blanchard, OK
NPI 1548601339 · NPPES record last updated Jul 9, 2013
Key facts
- NPI
- 1548601339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 1897 (OK)
- Practice address
- 2428 Ridge Run Dr
Blanchard, OK 73010-9034 - Phone
- (405) 627-0929
- NPI assigned
- Jul 9, 2013
- 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 |
|---|---|---|---|
| 1897 | OK | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1897 | OK | Yes |
Addresses
Primary practice location
2428 Ridge Run Dr
Blanchard, OK 73010-9034
Mailing address
2428 Ridge Run Dr
Blanchard, OK 73010-9034
Other providers in Blanchard, OK
- Cassie Jo Brown
- Tyler Adam Brown
- Brooklyne N. Brumley
- Leslie Diane Butler
- Gabriel Cannon
- Deborah A Charlton
- Martin Edward Christensen
- Christina Richardson
- Ashlee Lynn Cvikel
- Casey Louise Denton
All providers in Blanchard, OK · Physical Therapy Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2013. 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.