Provider Demographics
NPI:1740666791
Name:POTTEIGER, COURTNEY J (DPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:J
Last Name:POTTEIGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:J
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:5108 E TRINDLE RD
Practice Address - Street 2:STE 200
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3300
Practice Address - Country:US
Practice Address - Phone:717-790-9920
Practice Address - Fax:717-790-9923
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist