Individual
MR. DOUGLAS THOMAS KUTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150111792
IL
Other
Enumeration date
01/31/2024
Last updated
02/01/2024
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