Provider Demographics
NPI:1326670282
Name:UNGER, COURTNEY (PTA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:UNGER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:CHACON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:150 AGUILAR CT
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89441-6232
Mailing Address - Country:US
Mailing Address - Phone:530-301-9749
Mailing Address - Fax:
Practice Address - Street 1:16560 WEDGE PKWY STE 200-A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3318
Practice Address - Country:US
Practice Address - Phone:775-384-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-09
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50518225200000X
NVA-1693225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty