Provider Demographics
NPI:1629478334
Name:DONAGAN, KOURTNEY (DPT)
Entity Type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:
Last Name:DONAGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KOURTNEY
Other - Middle Name:
Other - Last Name:HARTMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:25241 ELEMENTARY WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7883
Mailing Address - Country:US
Mailing Address - Phone:239-947-4184
Mailing Address - Fax:239-947-4171
Practice Address - Street 1:12250 TAMIAMI TRL E STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-8108
Practice Address - Country:US
Practice Address - Phone:239-417-0027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29547225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist