Provider Demographics
NPI:1942086871
Name:KC CORPORATION
Entity Type:Organization
Organization Name:KC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KURTIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STRUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:406-378-2655
Mailing Address - Street 1:PO BOX 1246
Mailing Address - Street 2:
Mailing Address - City:BIG SANDY
Mailing Address - State:MT
Mailing Address - Zip Code:59520-1246
Mailing Address - Country:US
Mailing Address - Phone:406-378-2655
Mailing Address - Fax:
Practice Address - Street 1:1279 CLEVELAND ROAD
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:MT
Practice Address - Zip Code:59520
Practice Address - Country:US
Practice Address - Phone:406-378-2655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KC CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty