Provider Demographics
NPI:1831499458
Name:LINDHURST, KURT OLAF (MPT)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:OLAF
Last Name:LINDHURST
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 S BELSAY RD
Mailing Address - Street 2:STE G
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1948
Mailing Address - Country:US
Mailing Address - Phone:810-743-1611
Mailing Address - Fax:810-249-4230
Practice Address - Street 1:1096 S BELSAY RD
Practice Address - Street 2:STE G
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1948
Practice Address - Country:US
Practice Address - Phone:810-743-1611
Practice Address - Fax:810-249-4230
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010305225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist