Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 2769 | SC |
NPI | 1104026111 |
---|---|
Provider Name | Analyn M Mccutchen |
First Address | Inman, SC 29349 |
Second Address | Inman, SC 29349 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 19/07/2007 |