Provider Demographics
NPI:1942875182
Name:LAUGHLIN, COURTNEY RAE (DPT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7868 BIG HAND RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MI
Mailing Address - Zip Code:48063-3304
Mailing Address - Country:US
Mailing Address - Phone:810-305-2990
Mailing Address - Fax:
Practice Address - Street 1:5656 W US HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2454
Practice Address - Country:US
Practice Address - Phone:231-316-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501020030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist