MEDICARE: KURT M WALDERBACH PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	01369	IA

General Provider Information

NPI Number	:	1578696993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT M WALDERBACH PT

Provider Business Mailing Address
First Line	:	PO BOX 93
Second Line	:
City	:	CHARLES CITY
State	:	IA
Zip	:	50616-0093
Country	:	US
Telephone Number	:	641-715-1230
Fax Number	:	641-715-1231

Provider Business Practice Location Address
First Line	:	PO BOX 93
Second Line	:
City	:	CHARLES CITY
State	:	IA
Zip	:	50616-0093
Country	:	US
Telephone Number	:	641-715-1230
Fax Number	:	641-715-1231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	11/05/2024

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Directions to “ KURT M WALDERBACH PT” Practice Location

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