Individual
AMANDA KUTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-4677
Mailing address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-4677
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
WI
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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