Provider Demographics
NPI:1174611941
Name:HEUSSER, KURT V (PT)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:V
Last Name:HEUSSER
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 1:944 CLAREMONT DR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2313
Mailing Address - Country:US
Mailing Address - Phone:707-354-2469
Mailing Address - Fax:
Practice Address - Street 1:944 CLAREMONT DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-2313
Practice Address - Country:US
Practice Address - Phone:707-354-2469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1195022401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist