Provider Demographics
NPI:1356341192
Name:ZILLMANN, KURT MATTHEW (PT)
Entity type:Individual
Prefix:MR
First Name:KURT
Middle Name:MATTHEW
Last Name:ZILLMANN
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 1:24700 CENTER RIDGE RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5668
Mailing Address - Country:US
Mailing Address - Phone:440-777-3343
Mailing Address - Fax:440-777-3357
Practice Address - Street 1:24700 CENTER RIDGE RD STE 170
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5668
Practice Address - Country:US
Practice Address - Phone:440-777-3343
Practice Address - Fax:440-777-3357
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 004415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2413936Medicaid
OHP84939Medicare UPIN
OHZI4103364Medicare PIN