Individual
KYLE JOHN FRITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
734 20TH AVE, CLEAR LAKE, WI 54005-3923
(715) 607-4170
Mailing address
734 20TH AVE, CLEAR LAKE, WI 54005-3923
(715) 607-4170
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5779-27
WI
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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