Provider Demographics
NPI:1811617095
Name:CUTLER, BRIDGER THOMAS (DC)
Entity type:Individual
Prefix:
First Name:BRIDGER
Middle Name:THOMAS
Last Name:CUTLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 S 760 E
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-4555
Mailing Address - Country:US
Mailing Address - Phone:801-691-6855
Mailing Address - Fax:
Practice Address - Street 1:1770 E FORT UNION BLVD STE 101
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-2881
Practice Address - Country:US
Practice Address - Phone:385-200-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12937499-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor