Individual
CATHY WYATT KLOTZBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 COLUMBINE DR, CARLISLE, KY 40311-9051
(859) 289-3203
(859) 289-3203
Mailing address
200 COLUMBINE DR, CARLISLE, KY 40311-9051
(859) 289-3203
(859) 289-3203
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
01971
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01971
KY FIRST STEPS PSC CBIS #
KY
Enumeration date
03/21/2007
Last updated
07/08/2007
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