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NPI Code Detail

MEDICARE: LUKE KROMPETZ

MEDICARE:   LUKE  KROMPETZ
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
1225X00000XOccupational Therapist5201008416MI

General Provider Information

NPI Number : 1982113775
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKE KROMPETZ
Provider Business Mailing Address
First Line : 1919 NICKLESS RD
Second Line :
City : GLADWIN
State : MI
Zip : 48624-9764
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 W HIGH ST
Second Line :
City : MOUNT PLEASANT
State : MI
Zip : 48858-3028
Country : US
Telephone Number : 989-772-0258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2017
Last Update Date : 09/25/2017

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