Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2001002216 | MO |
NPI | 1003125659 |
---|---|
Provider Name | Mrs. Annika Eva Kurtz |
First Address | Saint Charles, MO 63301-6936 |
Second Address | Saint Charles, MO 63301-4358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2010 |
Last Update Date | 30/09/2010 |