Provider Demographics
NPI:1114093283
Name:MARCIA GUERTIN, P.A.
Entity Type:Organization
Organization Name:MARCIA GUERTIN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-990-2744
Mailing Address - Street 1:2311 HIGHWAY 52 N
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-7922
Mailing Address - Country:US
Mailing Address - Phone:507-990-2744
Mailing Address - Fax:507-282-9626
Practice Address - Street 1:2311 HIGHWAY 52 N
Practice Address - Street 2:SUITE C
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-7922
Practice Address - Country:US
Practice Address - Phone:507-990-2744
Practice Address - Fax:507-282-9626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center