Provider Demographics
NPI:1194449066
Name:YORK, COURTNEY MADISON (PT, DPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MADISON
Last Name:YORK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 KIANA CT
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-6787
Mailing Address - Country:US
Mailing Address - Phone:270-534-1200
Mailing Address - Fax:
Practice Address - Street 1:115 KIANA CT
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-6787
Practice Address - Country:US
Practice Address - Phone:270-534-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist