Individual
BRADLEY L KAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
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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