Provider Demographics
NPI:1649703950
Name:COURTS, AMAKA
Entity type:Individual
Prefix:
First Name:AMAKA
Middle Name:
Last Name:COURTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 WAKEFIELD DR APT C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:507 WAKEFIELD DR APT C
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3148
Practice Address - Country:US
Practice Address - Phone:704-285-8207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2023-11-14
Deactivation Date:2018-07-30
Deactivation Code:
Reactivation Date:2022-03-17
Provider Licenses
StateLicense IDTaxonomies
NC15461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist