Provider Demographics
NPI:1023183613
Name:CUTICH, DAVID J (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:CUTICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 THIRD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2531
Mailing Address - Country:US
Mailing Address - Phone:724-774-2144
Mailing Address - Fax:724-774-3307
Practice Address - Street 1:1311 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2531
Practice Address - Country:US
Practice Address - Phone:724-774-2144
Practice Address - Fax:724-774-3307
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003219L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010512830001Medicaid
PAT30347Medicare UPIN
PA0010512830001Medicaid