Individual
MR. KENNETH PITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12765 W HICKORY CT, NEW BERLIN, WI 53151-4613
(414) 258-8492
Mailing address
12765 W HICKORY CT, NEW BERLIN, WI 53151-4613
(414) 258-8492
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
620-027
WI
Other
Enumeration date
10/11/2013
Last updated
10/11/2013
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