Provider Demographics
NPI:1598884694
Name:GUTHRIE, BRETT ALAN
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ALAN
Last Name:GUTHRIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5756 RED ARROW HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127-1157
Mailing Address - Country:US
Mailing Address - Phone:269-429-4884
Mailing Address - Fax:269-429-8433
Practice Address - Street 1:5756 RED ARROW HWY STE 1
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49127-1157
Practice Address - Country:US
Practice Address - Phone:269-429-4884
Practice Address - Fax:269-429-8433
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N66980Medicare ID - Type Unspecified