Provider Demographics
NPI:1164735197
Name:GUERTIN, DANIEL E (ATC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:E
Last Name:GUERTIN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ROLLING GREEN DR APT D
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-7827
Mailing Address - Country:US
Mailing Address - Phone:508-932-3395
Mailing Address - Fax:
Practice Address - Street 1:14 ROLLING GREEN DR APT D
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-7827
Practice Address - Country:US
Practice Address - Phone:508-932-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA021062255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer