Provider Demographics
NPI:1093065005
Name:MACNAIR, KURT THOMAS (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:THOMAS
Last Name:MACNAIR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 HENRY AVE
Mailing Address - Street 2:APT. G 17
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2984
Mailing Address - Country:US
Mailing Address - Phone:267-664-5997
Mailing Address - Fax:
Practice Address - Street 1:8200 HENRY AVE
Practice Address - Street 2:APT. G 17
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2984
Practice Address - Country:US
Practice Address - Phone:267-664-5997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist