Provider Demographics
NPI:1558372227
Name:KILDOW, KURT ERIC (PT)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:ERIC
Last Name:KILDOW
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 1:155 DEER RUN LN
Mailing Address - Street 2:
Mailing Address - City:BEULAVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28518-8823
Mailing Address - Country:US
Mailing Address - Phone:910-298-4674
Mailing Address - Fax:
Practice Address - Street 1:159 CROSSOVER RD
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518-8801
Practice Address - Country:US
Practice Address - Phone:910-298-6455
Practice Address - Fax:910-298-6405
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21227225100000X
NCPT9484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist