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General NPI Number Information
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NPI Number | 1952758401
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Entity Type | Organization
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Legal Business Name | DOCTOR'S CHOICE MEDICAL MASSAGE
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Dates
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Enumeration Date | 05/14/2016
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Last Update Date | 05/14/2016
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Provider Practice Location Address
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Address Line | 910 MAJOR SHERMAN LN UNIT 200
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City | MONTEREY
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State | CA
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Zip | 93940-4642
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Country | US
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Telephone | 831-708-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 910 MAJOR SHERMAN LN UNIT 200
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City | MONTEREY
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State | CA
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Zip | 93940-4642
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Country | US
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Telephone | 831-708-8722
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TYLER B GUTTENBERGER
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Credential | LMT
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Telephone | 30358999052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 35418
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License Number State | CA
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