Provider Demographics
NPI:1760789341
Name:STONE, COURTNEY GAYLE (MPT)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:GAYLE
Last Name:STONE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1870 S CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-4418
Mailing Address - Country:US
Mailing Address - Phone:559-636-1200
Mailing Address - Fax:559-636-1260
Practice Address - Street 1:1132 E LELAND STREET
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2344
Practice Address - Country:US
Practice Address - Phone:559-684-0611
Practice Address - Fax:559-684-0612
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36116225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist