MEDICARE: REBECCA KURK PT, DPT

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	004947	KY

General Provider Information

NPI Number	:	1861270316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KURK PT, DPT

Provider Business Mailing Address
First Line	:	421 S 4TH ST STE 103
Second Line	:
City	:	DANVILLE
State	:	KY
Zip	:	40422-2083
Country	:	US
Telephone Number	:	859-324-6380
Fax Number	:	866-340-7914

Provider Business Practice Location Address
First Line	:	421 S 4TH ST STE 103
Second Line	:
City	:	DANVILLE
State	:	KY
Zip	:	40422-2083
Country	:	US
Telephone Number	:	859-324-6380
Fax Number	:	866-340-7914

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

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	09/18/2023

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