Provider Demographics
NPI:1679821797
Name:COURTNEY, ALICIA BRIDGETTE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:BRIDGETTE
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 BUFFALO RD
Mailing Address - Street 2:BUILDING 100-C
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1360
Mailing Address - Country:US
Mailing Address - Phone:585-247-0080
Mailing Address - Fax:585-426-7952
Practice Address - Street 1:2300 BUFFALO RD
Practice Address - Street 2:BUILDING 100-C
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1360
Practice Address - Country:US
Practice Address - Phone:585-247-0080
Practice Address - Fax:585-426-7952
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist