Provider Demographics
NPI:1639534779
Name:MCCOY, WHITNEY KNIGHT (PT, DPT)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:KNIGHT
Last Name:MCCOY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:LEIGHT
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:477 PROMINENCE CT STE 100
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-6377
Mailing Address - Country:US
Mailing Address - Phone:401-216-9564
Mailing Address - Fax:
Practice Address - Street 1:477 PROMINENCE CT STE 100
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6377
Practice Address - Country:US
Practice Address - Phone:401-216-9564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7844225100000X
GAPT013893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist