Healthcare Provider Details
I. General information
NPI: 1922187525
Provider Name (Legal Business Name): DAVID R KUTSCHMAN DC,CA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/03/2006
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
494 SYCAMORE AVENUE SUITE 205
SHREWSBURY NJ
07702-4218
US
IV. Provider business mailing address
494 SYCAMORE AVENUE SUITE 205
SHREWSBURY NJ
07702-4218
US
V. Phone/Fax
- Phone: 732-747-5022
- Fax: 732-747-5822
- Phone: 732-747-5022
- Fax: 732-747-5822
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 38MC00194700 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 25MZ00022900 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 001852-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: