1861184350 NPI number — READY SET GROW PEDIATRIC THERAPIES, LLC

Table of content: DR. DENNIS PAUL GUTZ DDS (NPI 1245301100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861184350 NPI number — READY SET GROW PEDIATRIC THERAPIES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
READY SET GROW PEDIATRIC THERAPIES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861184350
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
445 ROXIE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35633-1342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-483-0934
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1730 WEBSTER ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUSCLE SHOALS
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35661-2040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-576-1712
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2023

Additional Information

Authorized Official

Authorized Official Last Name:
CROSBY
Authorized Official First Name:
ASHLEY
Authorized Official Middle Name:
HESTER
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
256-483-0934

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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