Provider Demographics
NPI:1700492121
Name:HUVER, COURTNEY (PT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HUVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:TUINIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1908 W MILHAM AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-1232
Mailing Address - Country:US
Mailing Address - Phone:269-459-6212
Mailing Address - Fax:
Practice Address - Street 1:1908 W MILHAM AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-1232
Practice Address - Country:US
Practice Address - Phone:269-459-6212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501019722OtherSTATE LICENSE