Provider Demographics
NPI:1871724344
Name:HAMMEL, KIRK DAVID (CMT)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:DAVID
Last Name:HAMMEL
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:DOLLAR BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49922-0290
Mailing Address - Country:US
Mailing Address - Phone:906-483-0161
Mailing Address - Fax:
Practice Address - Street 1:47964 MADELEINE ST
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-2816
Practice Address - Country:US
Practice Address - Phone:906-221-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-01
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI576097-09225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist