Michael Kurita
Individual provider Active NPI Physical Therapist · Bloomfield, NM
NPI 1811496953 · NPPES record last updated Feb 5, 2018
Key facts
- NPI
- 1811496953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4907 (NM)
- Practice address
- 204A W Broadway Ave
Bloomfield, NM 87413-5903 - Phone
- (505) 333-7217
- NPI assigned
- Feb 5, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4907 | NM | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4907 | NM | Yes |
Addresses
Primary practice location
204A W Broadway Ave
Bloomfield, NM 87413-5903
Mailing address
15 Apex Dr
Highland, IL 62249-1282
Phone (618) 441-0482
Other providers in Bloomfield, NM
- Tonya Kaye Jordan
- Kare Inc
- Kare Inc.
- Angie Kiger-Legrand
- Monika Kos
- Mariah Kay Lasley-Miller
- Marichu Lazo
- Kerriann Maria Malott
- Kylie Spencer Mangan
- Jennifer I Martin
All providers in Bloomfield, NM · Physical Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.