Provider Demographics
NPI:1952648149
Name:STEVENSON, COURTNEY MORGAN (DPT, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:MORGAN
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11760 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1005
Mailing Address - Country:US
Mailing Address - Phone:804-364-3956
Mailing Address - Fax:804-364-3958
Practice Address - Street 1:11760 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1005
Practice Address - Country:US
Practice Address - Phone:804-364-3956
Practice Address - Fax:804-364-3958
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052043552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic