Provider Demographics
NPI:1801302088
Name:BRENDSTRUP, KURT (DC)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:BRENDSTRUP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SILVER LAKE CT
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-7709
Mailing Address - Country:US
Mailing Address - Phone:828-808-2606
Mailing Address - Fax:
Practice Address - Street 1:107 SILVER LAKE CT
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584-7709
Practice Address - Country:US
Practice Address - Phone:828-808-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-25
Last Update Date:2017-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1653111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition