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General NPI Number Information
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NPI Number | 1023228129
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Entity Type | Individual
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Provider Name | NANCY MELINDA GUTTRY PT
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23193 LA CADENA DR 102
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1482
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Country | US
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Telephone | 310-717-6801
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 GAYLEY AVE 1227
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City | LOS ANGELES
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State | CA
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Zip | 90024-3424
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Country | US
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Telephone | 310-717-6801
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12543
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License Number State | CA
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