Individual
LATISHIA N GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7621 WHITEWOOD DR, FLAGSTAFF, AZ 86004-9638
(928) 699-7745
Mailing address
7621 WHITEWOOD DR, FLAGSTAFF, AZ 86004-9638
(928) 699-7745
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
21-209
AZ
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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