Provider Demographics
NPI:1437455342
Name:CUTTER, CARLA (LMT)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:CUTTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-5201
Mailing Address - Country:US
Mailing Address - Phone:904-588-5361
Mailing Address - Fax:866-531-8858
Practice Address - Street 1:507 4TH ST S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-5201
Practice Address - Country:US
Practice Address - Phone:904-588-5361
Practice Address - Fax:866-531-8858
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMT#41496175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath