MEDICARE: ALEX KURIAN

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	225200000X	Physical Therapy Assistant	5502004812	MI

General Provider Information

NPI Number	:	1386116358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX KURIAN

Provider Business Mailing Address
First Line	:	46318 CORDOBA DR
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48374-2434
Country	:	US
Telephone Number	:	248-795-9924
Fax Number	:

Provider Business Practice Location Address
First Line	:	8633 MAIN ST
Second Line	:
City	:	WHITMORE LAKE
State	:	MI
Zip	:	48189-9248
Country	:	US
Telephone Number	:	734-449-4431
Fax Number	:	734-449-7192

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

Provider Enumeration Date	:	01/01/2019
Last Update Date	:	01/01/2019

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