Provider Demographics
NPI:1487881231
Name:KURTH CHIROPRACTIC S.C.
Entity type:Organization
Organization Name:KURTH CHIROPRACTIC S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-434-0268
Mailing Address - Street 1:320 W BROWN DEER RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2319
Mailing Address - Country:US
Mailing Address - Phone:414-434-0268
Mailing Address - Fax:414-434-0272
Practice Address - Street 1:320 W BROWN DEER RD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:WI
Practice Address - Zip Code:53217-2319
Practice Address - Country:US
Practice Address - Phone:414-434-0268
Practice Address - Fax:414-434-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty