Individual provider · NPI-1

Stacy Marie Gutierrez, A.T.,C.

Specialist/Technologist, Athletic Trainer · Southgate, MI

NPI number1598814840
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1598814840
Entity type
Individual (NPI-1)
Name
Miss Stacy Marie Gutierrez
Credential
A.T.,C.
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 9, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

14349 Leroy St
Southgate, MI 48195-2066

Phone 313-657-3675

Mailing address

14349 Leroy St
Southgate, MI 48195-2066

Phone 313-657-3675

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