Provider Demographics
NPI:1548272933
Name:COURIER, MARTHA JEAN (RKT CERT#1619)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:JEAN
Last Name:COURIER
Suffix:
Gender:F
Credentials:RKT CERT#1619
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:JEAN
Other - Last Name:KENDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RKT CERT#1619
Mailing Address - Street 1:205 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-4119
Mailing Address - Country:US
Mailing Address - Phone:228-872-7793
Mailing Address - Fax:
Practice Address - Street 1:400 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2410
Practice Address - Country:US
Practice Address - Phone:228-523-4641
Practice Address - Fax:228-523-5731
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSCERT 1619226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist