Provider Demographics
NPI:1801526652
Name:STANO, COURTNEY LYNNE (DPT, PT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LYNNE
Last Name:STANO
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4243 W BANCROFT ST APT 205W
Mailing Address - Street 2:
Mailing Address - City:OTTAWA HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:43615-3988
Mailing Address - Country:US
Mailing Address - Phone:248-535-6639
Mailing Address - Fax:
Practice Address - Street 1:2001 PERRYSBURG HOLLAND RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-7005
Practice Address - Country:US
Practice Address - Phone:419-861-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist