Individual
KAITLYN KOUTRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 BEL AIR SOUTH PKWY STE 1535, BEL AIR, MD 21015-3816
(410) 569-0044
Mailing address
5 BEL AIR SOUTH PKWY STE 1535, BEL AIR, MD 21015-3816
(410) 569-0044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA004651
PA
363AM0700X
Medical Physician Assistant
Primary
MA0600234
PA
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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