Provider Demographics
NPI:1265980379
Name:GUYTON, HEATHER (RRT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GUYTON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RRT
Mailing Address - Street 1:156 SEA MARSH CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-6624
Mailing Address - Country:US
Mailing Address - Phone:404-840-6907
Mailing Address - Fax:
Practice Address - Street 1:156 SEA MARSH CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-6624
Practice Address - Country:US
Practice Address - Phone:404-840-6907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-18
Last Update Date:2016-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5520227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered