Provider Demographics
NPI:1821057241
Name:MCCUTCHEN, DANIEL GENE (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:GENE
Last Name:MCCUTCHEN
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19336 H ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-3703
Mailing Address - Country:US
Mailing Address - Phone:402-708-0099
Mailing Address - Fax:
Practice Address - Street 1:1021 S 178TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3574
Practice Address - Country:US
Practice Address - Phone:402-933-3036
Practice Address - Fax:402-933-3163
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28342251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
7971554OtherAETNA
36047013OtherBLUE CROSS BLUE SHIELD
266642Medicare ID - Type Unspecified