Individual
ELIZABETH GAIL CICUTTO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
112 N WALNUT AVE, COOKEVILLE, TN 38501-2554
(931) 520-1414
(931) 520-1246
Mailing address
PO BOX 1210, COOKEVILLE, TN 38503-1210
(931) 520-1414
(931) 520-1246
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1336
TN
Other
Enumeration date
04/25/2006
Last updated
07/08/2007
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