Basic Information
| Provider Information | |||||||||
| NPI: | 1831412469 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUCH | ||||||||
| FirstName: | ADRIANNE | ||||||||
| MiddleName: | DENISE | ||||||||
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| Credential: | PT,DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 135 GOSHEN ROAD EXT STE 206 | ||||||||
| Address2: | |||||||||
| City: | RINCON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313265569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778261509 | ||||||||
| FaxNumber: | 9128269767 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 GOSHEN ROAD EXT STE 206 | ||||||||
| Address2: | |||||||||
| City: | RINCON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313265569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778261509 | ||||||||
| FaxNumber: | 9128269767 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2010 | ||||||||
| LastUpdateDate: | 03/10/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT009369 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.