Provider Demographics
NPI:1770038200
Name:EYRICH, JACQULYN MARIE (RRT)
Entity Type:Individual
Prefix:MRS
First Name:JACQULYN
Middle Name:MARIE
Last Name:EYRICH
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:MS
Other - First Name:JACQULYN
Other - Middle Name:MARIE
Other - Last Name:GUTTUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13923 S CAMINO EL BECERRO
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-7818
Mailing Address - Country:US
Mailing Address - Phone:520-909-9245
Mailing Address - Fax:
Practice Address - Street 1:3601 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-7818
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ011601227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered