Provider Demographics
NPI:1770613028
Name:CUMMINS, COURTNEY MICHELLE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:MICHELLE
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 NEWMARCH ST
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2440
Mailing Address - Country:US
Mailing Address - Phone:617-943-3455
Mailing Address - Fax:
Practice Address - Street 1:444 WASHINGTON ST
Practice Address - Street 2:SUITE 506
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1046
Practice Address - Country:US
Practice Address - Phone:781-937-9777
Practice Address - Fax:781-937-9767
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist