Provider Demographics
NPI:1053627950
Name:GUTHRIE, DELAINA DARBY (DPT)
Entity Type:Individual
Prefix:
First Name:DELAINA
Middle Name:DARBY
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 RYAN ST STE D
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8780
Mailing Address - Country:US
Mailing Address - Phone:337-439-3344
Mailing Address - Fax:337-439-3380
Practice Address - Street 1:3221 RYAN ST STE D
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8780
Practice Address - Country:US
Practice Address - Phone:337-439-3344
Practice Address - Fax:337-439-3380
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07802208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation