Provider Demographics
NPI:1730226713
Name:GEISEL, COURTNEY BROOKE (ATC)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:BROOKE
Last Name:GEISEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 CORNELL RD
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-9795
Mailing Address - Country:US
Mailing Address - Phone:517-930-0590
Mailing Address - Fax:
Practice Address - Street 1:530 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48937-1000
Practice Address - Country:US
Practice Address - Phone:517-930-0590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer