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General NPI Number Information
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NPI Number | 1740730498
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Entity Type | Individual
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Provider Name | KYLE VER BURG PT
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Gender | Male
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 26012 MIDDLE DR
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City | HARTFORD
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State | SD
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Zip | 57033-6344
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Country | US
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Telephone | 307-391-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 UNIVERSITY DR
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City | BISMARCK
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State | ND
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Zip | 58504-9634
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Country | US
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Telephone |
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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 | PT5914
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2642
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License Number State | SD
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