Thomas Cutlip

Individual provider Active NPI Physical Therapy Assistant · Winslow, AZ

NPI 1689910952 · NPPES record last updated Dec 14, 2012

Key facts

NPI
1689910952
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
0259A (AZ)
Practice address
826 W Desmond St
Winslow, AZ 86047-2321
Phone
(928) 289-4678
NPI assigned
Dec 14, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0259AAZMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0259A AZ Yes

Addresses

Primary practice location

826 W Desmond St
Winslow, AZ 86047-2321

Mailing address

6150 E Peaks Pkwy
Flagstaff, AZ 86004-5526

Other providers in Winslow, AZ

All providers in Winslow, AZ · Physical Therapy Assistant in Arizona

Sources for this page

Verify at the official NPI Registry.