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ALFRED V KOUTNIK

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1053590141

Individual Registrant:
 ALFRED V KOUTNIK 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
125 E 5TH ST  WALSENBURG, CO 81089-2020 US
Tel: 719-738-3160  Fax: 719-738-3170

Contact information for business:
125 E 5TH ST  WALSENBURG, CO 81089-2009 US
Tel: 719-738-3160  Fax: 719-738-3170

Registration Information:
NPI: 1053590141
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
COCO 2898

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
65135512CO05




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