Individual
BRONWEN GUTZWILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 SW A AVE, LAWTON, OK 73501-3821
(580) 357-8181
Mailing address
1202 SW A AVE, LAWTON, OK 73501-3821
(580) 357-8181
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669860763
—
OK
Enumeration date
12/26/2014
Last updated
07/27/2015
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