Provider Demographics
NPI:1851545271
Name:KAUR, SUKHPREET (PT)
Entity Type:Individual
Prefix:
First Name:SUKHPREET
Middle Name:
Last Name:KAUR
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 1:229 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-2545
Mailing Address - Country:US
Mailing Address - Phone:517-321-4646
Mailing Address - Fax:517-321-4825
Practice Address - Street 1:6114 WORTHMORE AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-9209
Practice Address - Country:US
Practice Address - Phone:517-321-4646
Practice Address - Fax:517-321-4825
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014135225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30658OtherBCBS
MI30658OtherBCBS