Healthcare Provider Details

I. General information

NPI: 1720908189
Provider Name (Legal Business Name): MICHAEL CUTLER MS, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 SOQUEL DR
APTOS CA
95003-3198
US

IV. Provider business mailing address

4615 SOQUEL WHARF RD
SOQUEL CA
95073-2133
US

V. Phone/Fax

Practice location:
  • Phone: 831-479-6448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: