Provider Demographics
NPI:1093322604
Name:GUTIERREZ, AARON PIMENTEL (LMT, MMP)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:PIMENTEL
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 2ND AVE E STE 400
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-1476
Mailing Address - Country:US
Mailing Address - Phone:205-353-9325
Mailing Address - Fax:
Practice Address - Street 1:309 2ND AVE E STE 400
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-1476
Practice Address - Country:US
Practice Address - Phone:205-353-9325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4815225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty