Provider Demographics
NPI:1730492380
Name:ANDREWS, COURTNEY BRASFIELD (PT)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:BRASFIELD
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3408
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-4015
Mailing Address - Country:US
Mailing Address - Phone:803-451-0247
Mailing Address - Fax:803-732-5996
Practice Address - Street 1:113 PROFESSIONAL PARK RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7847
Practice Address - Country:US
Practice Address - Phone:803-788-4705
Practice Address - Fax:803-788-4797
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6250OtherSTATE LICENSE