Healthcare Provider Details

I. General information

NPI: 1306840905
Provider Name (Legal Business Name): KURTZ PHYSICAL THERAPY SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 E MAIN ST
NORWICH NY
13815-1537
US

IV. Provider business mailing address

89 E MAIN ST
NORWICH NY
13815-1537
US

V. Phone/Fax

Practice location:
  • Phone: 607-336-3111
  • Fax: 607-336-2311
Mailing address:
  • Phone: 607-336-3111
  • Fax: 607-336-2311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0097551
License Number StateNY

VIII. Authorized Official

Name: MR. KEITH D. KURTZ
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 607-336-3111