Healthcare Provider Details
I. General information
NPI: 1760537369
Provider Name (Legal Business Name): ERIKA RAE KUHR ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 BOYDEN LANE
DEERFIELD MA
01342
US
IV. Provider business mailing address
PO BOX 116
DEERFIELD MA
01342-0116
US
V. Phone/Fax
- Phone: 413-774-1832
- Fax: 413-774-1427
- Phone: 413-774-1832
- Fax: 413-774-1427
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2255A2300X |
| Taxonomy | Athletic Trainer |
| License Number | 1663 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: