Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 11527 | MN |
Y | 2251S0007X | Physical Therapist - Sports | 0017309 | CO |
NPI | 1295288488 |
---|---|
Provider Name | David Kurbatsky |
First Address | Vail, CO 81658-7520 |
Second Address | Avon, CO 81620-6860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2016 |
Last Update Date | 06/12/2021 |