Provider Demographics
NPI:1568856052
Name:BOYLE, COURTENAY (DC)
Entity Type:Individual
Prefix:
First Name:COURTENAY
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:COURTENAY
Other - Middle Name:
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1433 HEATHER LN STE D
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2563
Mailing Address - Country:US
Mailing Address - Phone:980-201-8939
Mailing Address - Fax:
Practice Address - Street 1:1433 HEATHER LN STE D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2563
Practice Address - Country:US
Practice Address - Phone:980-201-8939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557224111N00000X
NC4785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor