Provider Demographics
NPI:1306975883
Name:MCCUTCHEON, REG (BCHIS)
Entity type:Individual
Prefix:MR
First Name:REG
Middle Name:
Last Name:MCCUTCHEON
Suffix:
Gender:M
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2517
Mailing Address - Country:US
Mailing Address - Phone:406-363-4363
Mailing Address - Fax:406-375-0360
Practice Address - Street 1:106 S 2ND ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2517
Practice Address - Country:US
Practice Address - Phone:406-363-4363
Practice Address - Fax:406-375-0360
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT200237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist