Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CP03403 | IN |
NPI | 1447791520 |
---|---|
Provider Name | Stephanie Jones-Cutler |
First Address | Fort Wayne, IN 46804-4135 |
Second Address | Indianapolis, IN 46250-2777 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2017 |
Last Update Date | 09/03/2017 |