Individual
DANIEL NORTHCUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1700 WHITE ST, MOUNT VERNON, IL 62864-4349
(618) 246-6763
Mailing address
PO BOX 504469, SAINT LOUIS, MO 63150-4469
(800) 677-1238
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056003358
IL
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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