Provider Demographics
NPI:1386752830
Name:CUTCHALL, LAURA RODGERS (PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RODGERS
Last Name:CUTCHALL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:L
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7751 GOLDFISH WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4524
Mailing Address - Country:US
Mailing Address - Phone:858-538-3038
Mailing Address - Fax:
Practice Address - Street 1:7751 GOLDFISH WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-4524
Practice Address - Country:US
Practice Address - Phone:858-603-3360
Practice Address - Fax:858-724-0292
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist