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General NPI Number Information
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NPI Number | 1467969832
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Entity Type | Organization
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Legal Business Name | KUT TO THE CHASE, LLC
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 608 EDMONDSON AVE STE 2
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City | CATONSVILLE
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State | MD
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Zip | 21228-3357
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Country | US
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Telephone | 443-518-9075
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21104
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City | CATONSVILLE
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State | MD
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Zip | 21228-0604
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Country | US
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Telephone | 443-518-9075
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Fax |
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Authorized Official
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Title or Position | OWNER/SPECIALIST
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Name | CHASE LEVAR ISOM
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Credential | CERTIFIED HAIR LOSS
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Telephone | 443-518-9075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 101749
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License Number State | MD
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