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General NPI Number Information
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NPI Number | 1306450143
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Entity Type | Individual
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Provider Name | REGAN MARIE GUESS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 1472 STOCKBRIDGE LN
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32084-1846
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Country | US
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Telephone | 423-930-0096
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Fax |
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Provider Business Mailing Address
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Address Line | 3531 MCKINLEY RD
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City | JOHNSON CITY
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State | TN
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Zip | 37604-7583
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Country | US
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Telephone | 423-930-0096
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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 | 36297
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | P21414
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License Number State | NC
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