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General NPI Number Information
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NPI Number | 1750406450
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Entity Type | Individual
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Provider Name | PETER J. KURTZ OD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 801 1ST ST
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City | MENOMINEE
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State | MI
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Zip | 49858-3231
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Country | US
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Telephone | 906-863-2330
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Fax | 906-863-3794
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Provider Business Mailing Address
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Address Line | 801 1ST ST
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City | MENOMINEE
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State | MI
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Zip | 49858-3231
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Country | US
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Telephone | 906-863-2330
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Fax | 906-863-3794
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002914
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License Number State | MI
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