Provider Demographics
NPI:1467672352
Name:CUTLER, MARC SCOTT (DOM, LAC)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:SCOTT
Last Name:CUTLER
Suffix:
Gender:M
Credentials:DOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 WINDSOR TRL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1253
Mailing Address - Country:US
Mailing Address - Phone:919-870-5804
Mailing Address - Fax:
Practice Address - Street 1:8351 STANDONSHIRE WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2760
Practice Address - Country:US
Practice Address - Phone:919-846-2239
Practice Address - Fax:919-846-2603
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC165171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist