Provider Demographics
NPI:1437383437
Name:SPRINGSTEAD, KURTIS CLIFTON (PT, DPT)
Entity type:Individual
Prefix:
First Name:KURTIS
Middle Name:CLIFTON
Last Name:SPRINGSTEAD
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:7925 STATE AVE STE 104
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112
Practice Address - Country:US
Practice Address - Phone:913-334-9931
Practice Address - Fax:913-334-9941
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014008564225100000X
KS11-03966225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1437383437OtherBCBS-KS
42612041OtherBCBS-KC
KSKA2868014OtherMEDICARE PTAN