Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1380 | AZ |
NPI | 1548286941 |
---|---|
Provider Name | Mr. Richard Alan Kutt |
First Address | Goodyear, AZ 85338-2030 |
Second Address | Phoenix, AZ 85012-1839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/07/2007 |