Provider Demographics
NPI:1982459103
Name:CUTLER, CHANDLER K (LMT)
Entity Type:Individual
Prefix:MR
First Name:CHANDLER
Middle Name:K
Last Name:CUTLER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 ROCKET BAR RD
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7929
Mailing Address - Country:US
Mailing Address - Phone:435-592-6577
Mailing Address - Fax:
Practice Address - Street 1:350 ROCKET BAR RD
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7929
Practice Address - Country:US
Practice Address - Phone:435-592-6577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8237539-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist