Provider Demographics
NPI:1649896911
Name:CUTRONE, GUILLERMO CARLOS (PT)
Entity type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:CARLOS
Last Name:CUTRONE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MAIN ST UNIT 11
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-1603
Mailing Address - Country:US
Mailing Address - Phone:317-828-9359
Mailing Address - Fax:
Practice Address - Street 1:8904A CROSS PARK DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4703
Practice Address - Country:US
Practice Address - Phone:865-236-0340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN126852251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic