Provider Demographics
NPI:1457863169
Name:MAGDICI, COURTNEY HARRISON
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:HARRISON
Last Name:MAGDICI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3488 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-3114
Mailing Address - Country:US
Mailing Address - Phone:270-993-1399
Mailing Address - Fax:
Practice Address - Street 1:5006 ATWOOD DR STE 2
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8179
Practice Address - Country:US
Practice Address - Phone:859-623-2057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic