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General NPI Number Information
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NPI Number | 1265724116
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Entity Type | Individual
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Provider Name | MONICA THERESE KUTZ OTR
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Gender | Female
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 422 3RD ST W SUITE 135
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City | ASHLAND
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State | WI
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Zip | 54806-1553
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Country | US
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Telephone | 715-682-0633
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Fax | 715-682-0736
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Provider Business Mailing Address
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Address Line | N10504 GRANDVIEW LN
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City | IRONWOOD
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State | MI
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Zip | 49938-9621
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Country | US
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Telephone | 906-932-5990
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Fax | 906-932-4153
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5034-26
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201007977
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License Number State | MI
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