Provider Demographics
NPI:1023539665
Name:COURTNEY, KIRSTEN MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:MICHELLE
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S FIGUEROA ST APT 1621
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2534
Mailing Address - Country:US
Mailing Address - Phone:870-718-9591
Mailing Address - Fax:
Practice Address - Street 1:714 W OLYMPIC BLVD STE 1001
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1695
Practice Address - Country:US
Practice Address - Phone:213-744-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor