Healthcare Provider Details

I. General information

NPI: 1861994170
Provider Name (Legal Business Name): KURT HISER OT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2098 S MAIN ST
ANN ARBOR MI
48103-5827
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109-5000
US

V. Phone/Fax

Practice location:
  • Phone: 734-232-7077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number5201006552
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: