Healthcare Provider Details

I. General information

NPI: 1033825088
Provider Name (Legal Business Name): KATHY LOTZER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60755 205TH ST
LITCHFIELD MN
55355-6483
US

IV. Provider business mailing address

60755 205TH ST
LITCHFIELD MN
55355-6483
US

V. Phone/Fax

Practice location:
  • Phone: 320-221-3242
  • Fax:
Mailing address:
  • Phone: 320-221-3242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1113899
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: