Provider Demographics
NPI:1346284874
Name:HERR, COURTNEY JEAN (ATC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JEAN
Last Name:HERR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DANA LN
Mailing Address - Street 2:
Mailing Address - City:EAST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02538-1248
Mailing Address - Country:US
Mailing Address - Phone:508-273-7119
Mailing Address - Fax:
Practice Address - Street 1:500 OLD BARNSTABLE RD
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3130
Practice Address - Country:US
Practice Address - Phone:508-539-3600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer