Basic Information
| Provider Information | |||||||||
| NPI: | 1104026111 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCUTCHEN | ||||||||
| FirstName: | ANALYN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | RPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 63 BLACSTOCK RD | ||||||||
| Address2: | |||||||||
| City: | INMAN | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644729055 | ||||||||
| FaxNumber: | 8644725115 | ||||||||
| Practice Location | |||||||||
| Address1: | 63 BLACSTOCK RD | ||||||||
| Address2: | |||||||||
| City: | INMAN | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644729055 | ||||||||
| FaxNumber: | 8644725115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2007 | ||||||||
| LastUpdateDate: | 07/19/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251G0304X | 2769 | SC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics |
No ID Information.