MEDICARE: MRS. ANNIKA EVA KURTZ P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2001002216	MO

General Provider Information

NPI Number	:	1003125659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNIKA EVA KURTZ P.T.

Provider Business Mailing Address
First Line	:	2758 HIGHWAY B
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-6936
Country	:	US
Telephone Number	:	314-489-0787
Fax Number	:

Provider Business Practice Location Address
First Line	:	3789 NEW TOWN BLVD
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-4358
Country	:	US
Telephone Number	:	636-669-2377
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/30/2010

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