Provider Demographics
NPI:1770665705
Name:GUYER, KATIE ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ELIZABETH
Last Name:GUYER
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 1:380 E 1500 S
Mailing Address - Street 2:102
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-3940
Mailing Address - Country:US
Mailing Address - Phone:435-657-4690
Mailing Address - Fax:435-657-4692
Practice Address - Street 1:380 E 1500 S
Practice Address - Street 2:102
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3940
Practice Address - Country:US
Practice Address - Phone:435-657-4690
Practice Address - Fax:435-657-4692
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6277645-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist