Provider Demographics
NPI:1689951642
Name:HUGHES, COURTNEY (MPT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4089 MOUNTAINBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:MORGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84050-8722
Mailing Address - Country:US
Mailing Address - Phone:801-865-5331
Mailing Address - Fax:
Practice Address - Street 1:4089 MOUNTAINBROOK WAY
Practice Address - Street 2:
Practice Address - City:MORGAN
Practice Address - State:UT
Practice Address - Zip Code:84050-8722
Practice Address - Country:US
Practice Address - Phone:801-865-5331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4907818-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist