Provider Demographics
NPI:1780694497
Name:GUZMAN, BETTE MCCOMBS (PT)
Entity type:Individual
Prefix:MS
First Name:BETTE
Middle Name:MCCOMBS
Last Name:GUZMAN
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 1:5180 BOULDER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-2308
Mailing Address - Country:US
Mailing Address - Phone:515-339-0405
Mailing Address - Fax:
Practice Address - Street 1:5180 BOULDER DR
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:IA
Practice Address - Zip Code:50327-2308
Practice Address - Country:US
Practice Address - Phone:515-339-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003555208100000X
IA004154225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist