MEDICARE: KARI TUTAK

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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1205213840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI TUTAK

Provider Business Mailing Address
First Line	:	5196 MARTIN RD
Second Line	:
City	:	NORTON SHORES
State	:	MI
Zip	:	49441-5662
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 PARK RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-4938
Country	:	US
Telephone Number	:	517-782-8888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2015
Last Update Date	:	05/04/2015

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Directions to “ KARI TUTAK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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