Provider Demographics
NPI:1255819686
Name:HARMS, COURTNEY C (PTA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:C
Last Name:HARMS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FAWN CIR
Mailing Address - Street 2:
Mailing Address - City:FOXFIRE VILLAGE
Mailing Address - State:NC
Mailing Address - Zip Code:27281-9760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 BLAKE BLVD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8474
Practice Address - Country:US
Practice Address - Phone:910-295-6158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA6499225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant