Basic Information
| Provider Information | |||||||||
| NPI: | 1659919264 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KURE | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | ALEXANDER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11900 WHITE BLUFF RD APT 1708 | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314191541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788492589 | ||||||||
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| Practice Location | |||||||||
| Address1: | 804 TOWNE PARK DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | RINCON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313265153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9128263797 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2019 | ||||||||
| LastUpdateDate: | 12/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | AT003179 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.