Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 38MC00121000 | NJ |
NPI | 1811094113 |
---|---|
Provider Name | Dr. Robert E. Mccutcheon |
First Address | Edison, NJ 08820 |
Second Address | Edison, NJ 08820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |