Individual
KELSEY KULTGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-2100
Mailing address
3741 RIVER LANE RD, PORT WASHINGTON, WI 53074-9786
(262) 305-2484
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5651
WI
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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