Provider Demographics
NPI:1326407107
Name:HUTTER, ROBERT
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HUTTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:PRASAD ROBERT
Other - Middle Name:
Other - Last Name:HUTTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAC, LAC
Mailing Address - Street 1:7339 CRESTHILL DR APT F10
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5919
Mailing Address - Country:US
Mailing Address - Phone:865-300-8125
Mailing Address - Fax:
Practice Address - Street 1:7339 CRESTHILL DR APT F10
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5919
Practice Address - Country:US
Practice Address - Phone:865-300-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist