Provider Demographics
NPI:1851919781
Name:KUTSCHE, CALEB THOMAS (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:THOMAS
Last Name:KUTSCHE
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 SHILOH RD NW APT 117
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6484
Mailing Address - Country:US
Mailing Address - Phone:770-653-5191
Mailing Address - Fax:
Practice Address - Street 1:4900 IVEY RD NW STE 1001
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4106
Practice Address - Country:US
Practice Address - Phone:770-917-0924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic