| Organization Name: | JACK W HUTTER SC |
| NPI Number: | 1063614048 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACK WILLIAM HUTTER (PRESIDENT) |
| Mailing Address: | 422 Summit Ave Oconomowoc |
| State: | WI US |
| Postal Code: | 530663749 |
| Phone Number: | 2625674724 |
| Fax Number: | 2625675195 |
| NPI Enumeration Date: | 06/02/2007 |
| NPI Last Update Date: | 06/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 474 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |