Healthcare Provider Details

I. General information

NPI: 1144620279
Provider Name (Legal Business Name): KURT ENGLE ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 MCCALL RD
MANHATTAN KS
66502-5032
US

IV. Provider business mailing address

426 MCCALL RD
MANHATTAN KS
66502-5032
US

V. Phone/Fax

Practice location:
  • Phone: 785-776-0670
  • Fax: 785-776-0096
Mailing address:
  • Phone: 785-776-0670
  • Fax: 785-776-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: