Individual
AMANDA MICHELE GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4-901 KUHIO HWY STE B, KAPAA, HI 96746-1549
(808) 826-6000
(844) 965-9830
Mailing address
4-901 KUHIO HWY STE B, KAPAA, HI 96746-1549
(808) 826-6000
(844) 965-9830
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
1189508
TX
2251X0800X
Orthopedic Physical Therapist
5501013684
MI
2251X0800X
Orthopedic Physical Therapist
Primary
5743
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206938701
—
TX
01
—
236742
MEDICARE
MI
01
—
30696
BCBS FACILITY ID
MI
Enumeration date
09/29/2008
Last updated
07/24/2023
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