| Doctor Name: | TRACY JOY GUTIERREZ |
| NPI Number: | 1508134883 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MT |
| License Number: | |
| Business Practice Address: | 107 H Street East Laboratory Poplar, MT - 592550067 |
| Business Phone Number: | 4067682172 |
| Business Fax Number: | 4067683435 |
| Mailing Address: | 107 H Street East, Laboratory POPLAR |
| State: | MT |
| Postal Code: | 592550067 |
| Phone Number: | 4067682172 |
| Fax Number: | 4067683435 |
| NPI Enumeration Date: | 12/01/2011 |
| NPI Last Update Date: | 12/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZA2600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Art, Medical |
| Taxonomy Definition: | |