Individual
JOHNATHON GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2808 NW 31ST ST, OKLAHOMA CITY, OK 73112-7407
(405) 848-7555
Mailing address
5537 NW 50TH ST APT D, OKLAHOMA CITY, OK 73122-5252
(405) 664-7460
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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