Provider Demographics
NPI:1023199015
Name:PIERCE, COURTNEY ANN (MPT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ANN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3902
Mailing Address - Country:US
Mailing Address - Phone:724-463-7478
Mailing Address - Fax:724-463-0931
Practice Address - Street 1:685 CAREY AVE
Practice Address - Street 2:
Practice Address - City:HANOVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18706-5489
Practice Address - Country:US
Practice Address - Phone:570-829-0539
Practice Address - Fax:570-829-4036
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017550225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50058334OtherCAPITAL/KHPC
PA1755237OtherHIGHMARK BLUE SHIELD
PA420157OtherHEALTH AMER/HEALTH ASSUR.
PA7964739OtherAETNA
PA820038OtherBCNE/FR. PRIORITY HEALTH
PA420157OtherHEALTH AMER/HEALTH ASSUR.