Healthcare Provider Details

I. General information

NPI: 1184390171
Provider Name (Legal Business Name): AUSTEN CUTARELLI MS, LAT, ATC, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE
AURORA CO
80045-7106
US

IV. Provider business mailing address

28179 DOUGLAS PARK RD
EVERGREEN CO
80439-8307
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-1234
  • Fax:
Mailing address:
  • Phone: 937-467-8224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number0002788
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: