Individual
MRS. KIMBERLY ANN CAUCUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
901 MULBERRY ST, LAKE MILLS, WI 53551-1335
(920) 648-8344
(920) 648-3441
Mailing address
PO BOX 212, WATERTOWN, WI 53094-0212
(920) 248-9727
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
919019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40481700
—
WI
Enumeration date
05/09/2007
Last updated
07/08/2007
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