Individual
BRADLEY L KAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100789
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076612700
—
MN
05
—
41069000
—
WI
01
—
670001950
RAILROAD MEDICARE
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
05
—
ENROLLED
—
WI
Enumeration date
01/26/2006
Last updated
03/09/2011
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