Provider Demographics
NPI:1548200033
Name:ARMBRUST, KURT WILLIAM (PT)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:WILLIAM
Last Name:ARMBRUST
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-1531
Mailing Address - Country:US
Mailing Address - Phone:413-684-0569
Mailing Address - Fax:
Practice Address - Street 1:777 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2140
Practice Address - Country:US
Practice Address - Phone:413-644-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY69319Medicare ID - Type UnspecifiedPROVIDER NUMBER