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General NPI Number Information
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NPI Number | 1023567708
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Entity Type | Individual
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Provider Name | ALLARAE KOUTZ ATC
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Gender | Female
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 29776 WOLFE RD
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-9734
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Country | US
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Telephone | 740-701-5956
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Fax |
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Provider Business Mailing Address
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Address Line | 2437 MADISON RD APT 2
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City | CINCINNATI
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State | OH
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Zip | 45208-1215
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Country | US
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Telephone | 740-701-5956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000029007
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License Number State | OH
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