Provider Demographics
NPI:1578788485
Name:GUTSCHICK, JOANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:GUTSCHICK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 IRENE DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-3612
Mailing Address - Country:US
Mailing Address - Phone:702-293-1683
Mailing Address - Fax:702-651-5506
Practice Address - Street 1:901 ADAMS BLVD
Practice Address - Street 2:HOME HEALTH OFFICE
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-2213
Practice Address - Country:US
Practice Address - Phone:702-293-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV709225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist