Individual
TAYLER PAIGE GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1112 OAK ST, CARMI, IL 62821-1344
(618) 382-2927
Mailing address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.007185
IL
Other
Enumeration date
09/11/2015
Last updated
10/03/2017
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