Provider Demographics
NPI:1831826312
Name:HARE, COURTNEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HARE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:503 BRAVES FIELD DR
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-4597
Mailing Address - Country:US
Mailing Address - Phone:912-667-0016
Mailing Address - Fax:
Practice Address - Street 1:105 E BACON ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:GA
Practice Address - Zip Code:31321-4750
Practice Address - Country:US
Practice Address - Phone:912-653-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist