Provider Demographics
NPI:1508231564
Name:MCNAMARA, COURTNEY (DPT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 JOYCE CTR
Mailing Address - Street 2:
Mailing Address - City:NOTRE DAME
Mailing Address - State:IN
Mailing Address - Zip Code:46556-5678
Mailing Address - Country:US
Mailing Address - Phone:781-413-7090
Mailing Address - Fax:
Practice Address - Street 1:113 JOYCE CTR
Practice Address - Street 2:
Practice Address - City:NOTRE DAME
Practice Address - State:IN
Practice Address - Zip Code:46556-5678
Practice Address - Country:US
Practice Address - Phone:781-413-7090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002639A2255A2300X
IN05011902A2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer