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NPI Code Detail

MEDICARE: NANCY L KAUTZER PT

MEDICARE: NANCY L KAUTZER PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1998-024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205095312
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY L KAUTZER PT
Provider Business Mailing Address
First Line : 410 DEWEY ST
Second Line : PO BOX 8080
City : WISCONSIN RAPIDS
State : WI
Zip : 54494-4715
Country : US
Telephone Number : 715-421-7599
Fax Number : 715-421-7517
Provider Business Practice Location Address
First Line : 1041 HILL ST
Second Line :
City : WISCONSIN RAPIDS
State : WI
Zip : 54494-5221
Country : US
Telephone Number : 715-423-6060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2008
Last Update Date : 06/03/2008

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