Provider Demographics
NPI:1780376889
Name:CUTSHALL, JOSHUA (DPT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:CUTSHALL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 W MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331
Mailing Address - Country:US
Mailing Address - Phone:914-294-0450
Mailing Address - Fax:631-760-8306
Practice Address - Street 1:1335 W MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331
Practice Address - Country:US
Practice Address - Phone:616-888-3184
Practice Address - Fax:231-830-9196
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501302370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty