Christina Gutierrez, OTR
Individual provider Active NPI Specialist · Demotte, IN
NPI 1689701591 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689701591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 31003274A (IN)
- Practice address
- 5522 E 989 N
Demotte, IN 46310-8016 - Phone
- (219) 756-4695
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31003274A | IN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana Fitness Works Inc | Past |
Accepting new patients | |
| 21St Century Total Wellness | Past | Accepting new patients | |
| 21St Century Total Wellness, LLC | Specialist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 31003274A | IN | Yes |
Addresses
Primary practice location
5522 E 989 N
Demotte, IN 46310-8016
Mailing address
6249 W 136TH PL
Cedar Lake, IN 46303-8667
Phone (219) 776-2688
Other providers in Demotte, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.