Provider Demographics
NPI:1295060838
Name:KURTZ, ANDREW DAVID (DPT)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DAVID
Last Name:KURTZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:19119 N CREEK PKWY
Practice Address - Street 2:STE 107
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8036
Practice Address - Country:US
Practice Address - Phone:425-486-8800
Practice Address - Fax:425-486-8848
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60108403225100000X
GA009612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0290918OtherDEPT. OF LABOR AND INDUSTRIES
WA0290918OtherDEPT. OF LABOR AND INDUSTRIES