Kothbauer, Brian

Kothbauer, Brian is an sole proprietor health care provider with primary practice located at 814 Jackson St , Stoughton WI 53589-1520. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Kothbauer, Brian can be contacted via phone (608) 873-6448.

Contact Information

Primary practice address
814 Jackson St Stoughton WI 53589-1520
Phone: (608) 873-6448
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 2799-154 Wisconsin

Profile Details

NPI number 1982813762
LBN Legal business name Kothbauer, Brian
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2007
Last updated Jul 9th, 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 1982813762 NPPES
Wisconsin MEDICAID 42585200

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