Provider Demographics
NPI:1013620335
Name:DEXTER, COURTNEY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:LYNN
Last Name:DEXTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 ONEIL CT STE 21
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7649
Mailing Address - Country:US
Mailing Address - Phone:803-788-8831
Mailing Address - Fax:803-788-8846
Practice Address - Street 1:224 ONEIL CT STE 21
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7649
Practice Address - Country:US
Practice Address - Phone:803-788-8831
Practice Address - Fax:803-788-8846
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor