MEDICARE: PHOEBE KATHERINE KUTTERNA D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC009899	PA

General Provider Information

NPI Number	:	1891971941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHOEBE KATHERINE KUTTERNA D.C.

Provider Business Mailing Address
First Line	:	7686 W RIDGE RD
Second Line	:	P.O. BOX 369
City	:	FAIRVIEW
State	:	PA
Zip	:	16415-1074
Country	:	US
Telephone Number	:	814-474-5588
Fax Number	:	814-474-5589

Provider Business Practice Location Address
First Line	:	4827 CRAYTON RD
Second Line	:
City	:	WEST SPRINGFIELD
State	:	PA
Zip	:	16443-9746
Country	:	US
Telephone Number	:	814-273-0800
Fax Number	:	814-474-5589

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	06/23/2008

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