Provider Demographics
NPI:1831132067
Name:LURI, ERNEST D (LPT)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:D
Last Name:LURI
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:QUINNESEC
Mailing Address - State:MI
Mailing Address - Zip Code:49876-9622
Mailing Address - Country:US
Mailing Address - Phone:906-779-1527
Mailing Address - Fax:
Practice Address - Street 1:325 H ST.
Practice Address - Street 2:117
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801
Practice Address - Country:US
Practice Address - Phone:906-774-3300
Practice Address - Fax:906-779-3187
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist