Individual
DR. WILLIAM O KAUTH SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D, ATC
Contact information
Practice address
510 AMHERST DR, NORMAL, IL 61761-2417
(309) 452-6486
Mailing address
510 AMHERST DR, NORMAL, IL 61761-2417
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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