Provider Demographics
NPI:1104852268
Name:CHAPMAN, KURT K (PT DPT CSCS)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:K
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:PT DPT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 ELSIE ST
Mailing Address - Street 2:
Mailing Address - City:FORT ATKINSON
Mailing Address - State:WI
Mailing Address - Zip Code:53538-1514
Mailing Address - Country:US
Mailing Address - Phone:608-201-0641
Mailing Address - Fax:262-458-2999
Practice Address - Street 1:1261 ELSIE ST
Practice Address - Street 2:
Practice Address - City:FORT ATKINSON
Practice Address - State:WI
Practice Address - Zip Code:53538-1514
Practice Address - Country:US
Practice Address - Phone:608-201-0641
Practice Address - Fax:262-458-2999
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5792024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40383700Medicaid