Provider Demographics
NPI:1073920021
Name:CHRISTMAN, COURTNEY EVE (PT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:EVE
Last Name:CHRISTMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:EVE
Other - Last Name:RENSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52 RISING SUN TOWN CTR
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911-1902
Practice Address - Country:US
Practice Address - Phone:410-658-0100
Practice Address - Fax:410-658-0199
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023865225100000X
MD25446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408569ZBL8Medicare PIN