Provider Demographics
NPI:1811442015
Name:KURSIK, EMILY (LPTA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KURSIK
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 LOVEJOY RD
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:MI
Mailing Address - Zip Code:48418-8854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1085 S LINDEN RD STE 100
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3416
Practice Address - Country:US
Practice Address - Phone:810-262-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004998225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant