| John Courtney Llc | |
|
118 Terra Bella Blvd Suite 101 Covington LA 70433-8148 | |
| (504) 208-9476 | |
| Not Available |
| Full Name | John Courtney Llc |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 118 Terra Bella Blvd, Covington, Louisiana |
| Authorized Official Name and Position | John C Courtney (OWNER) |
| Authorized Official Contact | 5042089476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Courtney Llc 118 Terra Bella Blvd Suite 101 Covington LA 70433-8148 Ph: (504) 208-9476 | John Courtney Llc 118 Terra Bella Blvd Suite 101 Covington LA 70433-8148 Ph: (504) 208-9476 |
| NPI Number | 1669887907 |
|---|---|
| Provider Enumeration Date | 06/25/2014 |
| Last Update Date | 06/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669887907 | NPI | - | NPPES |
| 1004812 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | MPAP (Louisiana) | Primary |
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