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General NPI Number Information
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NPI Number | 1225154834
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Entity Type | Organization
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Legal Business Name | MARQUETTE ORTHOPEDIC AND SPORTS THERAPY INC.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 1007 HARBOR HILLS DR SUITE A
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City | MARQUETTE
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State | MI
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Zip | 49855-8859
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Country | US
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Telephone | 906-225-5585
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Fax | 906-225-5990
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Provider Business Mailing Address
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Address Line | 1007 HARBOR HILLS DR SUITE A
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City | MARQUETTE
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State | MI
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Zip | 49855-8859
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Country | US
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Telephone | 906-225-5585
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Fax | 906-225-5990
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Authorized Official
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Title or Position | PRESIDENT P.T./CLINIC OWNER
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Name | MR. KURT ROBERT KERRY
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Credential | P.T.
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Telephone | 906-225-5585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501005513
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License Number State | MI
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