Provider Demographics
NPI:1295004141
Name:KAUR, GURNEET
Entity Type:Individual
Prefix:
First Name:GURNEET
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 COOLIDGE HWY
Mailing Address - Street 2:APT 106
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3637
Mailing Address - Country:US
Mailing Address - Phone:248-403-0282
Mailing Address - Fax:
Practice Address - Street 1:2626 GLENWOOD AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-1043
Practice Address - Country:US
Practice Address - Phone:919-781-9565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35810225100000X
NCP13504225100000X
MI550104043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty