Healthcare Provider Details

I. General information

NPI: 1942698782
Provider Name (Legal Business Name): AMY KUITSE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2015
Last Update Date: 01/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 TENDERFOOT HILL RD
COLORADO SPRINGS CO
80906-3903
US

IV. Provider business mailing address

5336 CLIFF POINT CIR W
COLORADO SPRINGS CO
80919-7911
US

V. Phone/Fax

Practice location:
  • Phone: 574-850-2101
  • Fax:
Mailing address:
  • Phone: 574-850-2101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0003503
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: