MEDICARE: CHRISTOPHER ADAM KOTTWITZ PT, DPT

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	225100000X	Physical Therapist	1291231	TX

General Provider Information

NPI Number	:	1902327794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER ADAM KOTTWITZ PT, DPT

Provider Business Mailing Address
First Line	:	141 CRIMSON SKY CT
Second Line	:
City	:	ALEDO
State	:	TX
Zip	:	76008-1316
Country	:	US
Telephone Number	:	210-216-6367
Fax Number	:	469-532-0204

Provider Business Practice Location Address
First Line	:	2921 LACKLAND RD STE 101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-4173
Country	:	US
Telephone Number	:	210-216-6367
Fax Number	:

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

Provider Enumeration Date	:	06/30/2017
Last Update Date	:	05/31/2022

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