Provider Demographics
NPI:1538279971
Name:SCHURMAN, KATHRYN SARA (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:SARA
Last Name:SCHURMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-1772
Mailing Address - Country:US
Mailing Address - Phone:612-986-4567
Mailing Address - Fax:
Practice Address - Street 1:790 MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:MN
Practice Address - Zip Code:55309-8832
Practice Address - Country:US
Practice Address - Phone:763-263-3684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist