Doctor Name: | CHRISTOPHER ALLEN GUGGOLZ |
NPI Number: | 1255674768 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 1616 |
Business Practice Address: | 24276 166th Airport Rd Eagle Butte, SD - 57625 |
Business Phone Number: | 6059640661 |
Business Fax Number: | 6059641171 |
Mailing Address: | Po Box 1786, EAGLE BUTTE |
State: | SD |
Postal Code: | 576251786 |
Phone Number: | 6054151147 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2013 |
NPI Last Update Date: | 04/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 1616 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |