Provider Demographics
NPI:1700513454
Name:MIRIAM GUERRERO
Entity Type:Organization
Organization Name:MIRIAM GUERRERO
Other - Org Name:MIRIAM GUERRERO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-704-0668
Mailing Address - Street 1:1410 FRANK CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-5673
Mailing Address - Country:US
Mailing Address - Phone:931-704-0668
Mailing Address - Fax:
Practice Address - Street 1:1410 FRANK CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-5673
Practice Address - Country:US
Practice Address - Phone:931-704-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy