Individual
DIEGO FERNANDO HERRERA GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
6000 MEADOWBROOK MALL CT STE 22, CLEMMONS, NC 27012-8775
(336) 778-0292
Mailing address
406 SALEM SPRINGS DR, WINSTON SALEM, NC 27107-1594
(743) 201-8938
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
13333
NC
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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