Provider Demographics
NPI:1154339745
Name:CUTLER, BRIGITTE JANE (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:BRIGITTE
Middle Name:JANE
Last Name:CUTLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-3493
Mailing Address - Country:US
Mailing Address - Phone:217-553-7172
Mailing Address - Fax:217-546-3302
Practice Address - Street 1:1210 CHURCHILL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-3493
Practice Address - Country:US
Practice Address - Phone:217-553-7172
Practice Address - Fax:217-546-3302
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08432143OtherBLUE CROSS BLUE SHEILD
IL08432143OtherBLUE CROSS BLUE SHEILD