MEDICARE: DR. VICTOR V KUTSAR DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	6238	OR
2	225700000X	Massage Therapist	21766	OR
3	111N00000X	Chiropractor	2023049802	MO

General Provider Information

NPI Number	:	1508231788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR V KUTSAR DC

Provider Business Mailing Address
First Line	:	524 SE 14TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-2428
Country	:	US
Telephone Number	:	971-544-7058
Fax Number	:	971-244-9058

Provider Business Practice Location Address
First Line	:	3611 MAIN ST STE 103
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-1932
Country	:	US
Telephone Number	:	816-561-7035
Fax Number	:	816-203-4819

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2015
Last Update Date	:	01/22/2024

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Directions to “ DR. VICTOR V KUTSAR DC” Practice Location

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