Provider Demographics
NPI:1891971941
Name:KUTTERNA, PHOEBE KATHERINE (DC)
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:KATHERINE
Last Name:KUTTERNA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7686 W RIDGE RD
Mailing Address - Street 2:P.O. BOX 369
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-1074
Mailing Address - Country:US
Mailing Address - Phone:814-474-5588
Mailing Address - Fax:814-474-5589
Practice Address - Street 1:4827 CRAYTON RD
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:16443-9746
Practice Address - Country:US
Practice Address - Phone:814-273-0800
Practice Address - Fax:814-474-5589
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor