Provider Demographics
NPI:1457027781
Name:KAUTZMANN, BRETT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:KAUTZMANN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2996 COTTON CREEK PL
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-3659
Mailing Address - Country:US
Mailing Address - Phone:307-262-7923
Mailing Address - Fax:
Practice Address - Street 1:4155 LEGION LN # 1&2
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-1946
Practice Address - Country:US
Practice Address - Phone:307-262-7923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-2096261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy