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NPI 1184390171

NPI 1184390171 : AUSTEN CUTARELLI : COLUMBUS, OH

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General NPI Number Information
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    NPI Number           |    1184390171
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    Entity Type          |    Individual 
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    Provider Name        |    AUSTEN CUTARELLI
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/19/2021
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    Last Update Date     |    08/19/2021
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Provider Practice Location Address
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    Address Line         |    80 W 11TH AVE RM 768 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43210-1313
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    Country              |    US
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    Telephone            |    937-467-8224
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    80 W 11TH AVE RM 768 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43210-1313
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    Country              |    US
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    Telephone            |    937-467-8224
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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