Individual
JONATHAN MCCUTCHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4970 OAKLAND AVE, SAINT LOUIS, MO 63110-1402
(314) 809-8519
Mailing address
5398 PERSHING AVE APT 3E, SAINT LOUIS, MO 63112-1788
(314) 809-8519
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2013039015
MO
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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