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General NPI Number Information
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NPI Number | 1477155174
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Entity Type | Individual
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Provider Name | KAITLYN KURTAGA DPT
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Gender | Female
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 303 S MILL ST STE 5
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City | CLIO
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State | MI
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Zip | 48420-2307
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Country | US
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Telephone | 810-687-8700
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Fax | 810-687-8724
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Provider Business Mailing Address
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Address Line | 9339 MEADOWVIEW DR
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City | DAVISON
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State | MI
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Zip | 48423-7808
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Country | US
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Telephone | 810-931-6008
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5501019803
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License Number State | MI
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