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MR. COURTNEY L SMALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
350 5TH AVE, SUITE 5115, NEW YORK, NY 10118-0110
(866) 601-6474
(212) 928-9545
Mailing address
1230 WOODYCREST AVE APT 2C, BRONX, NY 10452-3729

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006597-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006597-1
STATE LISCENSE
NY
Enumeration date
09/28/2007
Last updated
09/28/2007
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