Caucutt, Kimberly Ann

Caucutt, Kimberly Ann is an sole proprietor health care provider with primary practice located at 901 Mulberry St , Lake Mills WI 53551-1335. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Caucutt, Kimberly Ann can be contacted via phone (920) 648-8344.

Contact Information

Primary practice address
901 Mulberry St Lake Mills WI 53551-1335
Phone: (920) 648-8344
Fax: (920) 648-3441
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 919019 Wisconsin

Profile Details

NPI number 1366656654
LBN Legal business name Caucutt, Kimberly Ann
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366656654 NPPES
Wisconsin MEDICAID 40481700

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