Provider Demographics
NPI:1871330050
Name:KUTRIEB, HAYDEN NICHOLAS (DC)
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:NICHOLAS
Last Name:KUTRIEB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 EXECUTIVE DR STE E2
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2611
Mailing Address - Country:US
Mailing Address - Phone:812-887-4800
Mailing Address - Fax:
Practice Address - Street 1:6020 CRAWFORDSVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-3710
Practice Address - Country:US
Practice Address - Phone:317-957-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003463A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor