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NPI Code Detail

MEDICARE: DAVID BERNARD GUERTLER LCSW

MEDICARE: DAVID BERNARD GUERTLER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6067808-3501UT

General Provider Information

NPI Number : 1760132625
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BERNARD GUERTLER LCSW
Provider Business Mailing Address
First Line : 1664 S DIXIE DR STE E102
Second Line :
City : ST GEORGE
State : UT
Zip : 84770-7329
Country : US
Telephone Number : 435-703-9647
Fax Number : 435-703-6003
Provider Business Practice Location Address
First Line : 1789 N WEDGEWOOD LN STE 1
Second Line :
City : CEDAR CITY
State : UT
Zip : 84721-7769
Country : US
Telephone Number : 435-703-9647
Fax Number : 435-703-6003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2022
Last Update Date : 08/30/2023

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