MEDICARE: LORI M KUHN PTA

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	225200000X	Physical Therapy Assistant	832-019	WI

General Provider Information

NPI Number	:	1992916746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI M KUHN PTA

Provider Business Mailing Address
First Line	:	W7480 COUNTY ROAD V
Second Line	:
City	:	CASCADE
State	:	WI
Zip	:	53011-1231
Country	:	US
Telephone Number	:	920-528-7738
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 E CLIFFORD ST
Second Line	:
City	:	PLYMOUTH
State	:	WI
Zip	:	53073-2438
Country	:	US
Telephone Number	:	920-892-2654
Fax Number	:

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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