Betty Lee Courson, PTA
Physical Therapy Assistant in Hazlehurst, GA. Individual provider (NPI-1).
NPI number1962568030
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1962568030
- Entity type
- Individual (NPI-1)
- Name
- Betty Lee Courson
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 30, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | PTA000656 | GA | Yes |
Other names
- Betty Lee Clements (Former Name)
Practice location
200 S Tallahassee StHazlehurst, GA 31539-6024
Phone 912-375-7009 · Fax 912-375-7055
Mailing address
3615 Lake Mayers RdBaxley, GA 31513-8537
Phone 912-367-3551
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physical Therapy Assistant providers in Hazlehurst, GA
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