Provider Demographics
NPI:1750998670
Name:GUICE, PATRICIA M (LMT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:GUICE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2780
Mailing Address - Country:US
Mailing Address - Phone:419-352-8946
Mailing Address - Fax:419-352-8947
Practice Address - Street 1:536 PEARL ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2780
Practice Address - Country:US
Practice Address - Phone:419-352-8946
Practice Address - Fax:419-352-8947
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.025106225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist