Individual
MALLORY GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, PCS
Contact information
Practice address
8300 EARHART BLVD, NEW ORLEANS, LA 70118-4428
(504) 866-6990
Mailing address
4716 JANICE AVE, KENNER, LA 70065-3339
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09570R
LA
2251P0200X
Pediatric Physical Therapist
09570R
LA
Other
Enumeration date
09/10/2017
Last updated
09/10/2017
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