Provider Demographics
NPI:1033519152
Name:GONZALES, COURTNEY DANIELLE (DPT)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:DANIELLE
Last Name:GONZALES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SWORD HEALTH INC. 65 E WADSWORTH PARK DRIVE,
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020
Mailing Address - Country:US
Mailing Address - Phone:512-797-9288
Mailing Address - Fax:
Practice Address - Street 1:SWORD HEALTH INC. 65 E WADSWORTH PARK DRIVE,
Practice Address - Street 2:SUITE 230
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020
Practice Address - Country:US
Practice Address - Phone:512-797-9288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.026216225100000X
SD2393225100000X
CT13812225100000X
CA301541225100000X
MN12557225100000X
TX1246102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist