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Individual

MRS. AMY JEAN KUTKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1807 W MOLINE ST, MALVERN, AR 72104-2645
(501) 337-2731
Mailing address
135 CATHERINE COVE LOOP, MALVERN, AR 72104-8363
(501) 337-2731

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1303
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139280721
AR
Enumeration date
04/21/2006
Last updated
09/13/2011
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