Individual
RICHARD ANTHONY GUERRERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
717 W 16TH ST, PUEBLO, CO 81003-2110
(719) 242-5470
Mailing address
717 W 16TH ST, PUEBLO, CO 81003-2110
(719) 242-5470
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1003117
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003117
MEDICARE
CO
Enumeration date
08/20/2012
Last updated
08/20/2012
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