Individual
MARJORIE ANN GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HCP
Contact information
Practice address
1407 N MICHIGAN ST, PLYMOUTH, IN 46563-1119
(574) 941-2220
(574) 941-2227
Mailing address
1407 N MICHIGAN ST, PLYMOUTH, IN 46563-1119
(574) 941-2220
(574) 941-2227
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
17001319A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17001319A
INDIANA STATE LICENSE
IN
Enumeration date
12/26/2017
Last updated
06/16/2018
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