Healthcare Provider Details
I. General information
NPI: 1760390900
Provider Name (Legal Business Name): KATE L KUTZ LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
217 6TH AVE S
CLINTON IA
52732-4305
US
IV. Provider business mailing address
1235 4TH AVE N
CLINTON IA
52732-4848
US
V. Phone/Fax
- Phone: 815-858-5533
- Fax:
- Phone: 815-858-5533
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 079792 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: