Provider Demographics
NPI:1154821833
Name:COURT, DAVID (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:COURT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23319 MIDDLESEX ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2526
Mailing Address - Country:US
Mailing Address - Phone:586-219-6815
Mailing Address - Fax:
Practice Address - Street 1:17150 WATERLOO ST
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-1201
Practice Address - Country:US
Practice Address - Phone:313-343-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist