Provider Demographics
NPI:1215544119
Name:KUREK, MICHAEL (PT, DPT, ATC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:KUREK
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 28TH ST SE
Mailing Address - Street 2:APT 204
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6843
Mailing Address - Country:US
Mailing Address - Phone:920-979-5046
Mailing Address - Fax:
Practice Address - Street 1:1512 W SERVICE DR
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-2540
Practice Address - Country:US
Practice Address - Phone:507-474-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15195-24225100000X
MN12048225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist