Provider Demographics
NPI:1891563409
Name:HESS-DRAGOVICH, COURTNEY MICHELLE (LMT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MICHELLE
Last Name:HESS-DRAGOVICH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 CHERRY WAY DR STE 500
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6782
Mailing Address - Country:US
Mailing Address - Phone:614-407-1225
Mailing Address - Fax:614-522-6760
Practice Address - Street 1:1329 CHERRY WAY DR STE 500
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6782
Practice Address - Country:US
Practice Address - Phone:614-407-1225
Practice Address - Fax:614-522-6760
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.024756225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty