Provider Demographics
NPI:1396222667
Name:KURTEK, KYLE ROBERT (OTR/L)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:ROBERT
Last Name:KURTEK
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-4003
Mailing Address - Country:US
Mailing Address - Phone:570-294-4585
Mailing Address - Fax:
Practice Address - Street 1:2616 WEST 3RD ST.
Practice Address - Street 2:
Practice Address - City:MT. CARMEL
Practice Address - State:PA
Practice Address - Zip Code:17851
Practice Address - Country:US
Practice Address - Phone:570-339-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist