Provider Demographics
NPI:1255731485
Name:KINSER, COURTNEY COATES (LPTA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:COATES
Last Name:KINSER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:COATES
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5435 BEAVERKILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2359
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9707 MEDICAL CENTER DR STE 330
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6343
Practice Address - Country:US
Practice Address - Phone:301-444-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4159225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant