Provider Demographics
NPI:1053697375
Name:HARTIG, GUDRUN A (CMT)
Entity type:Individual
Prefix:
First Name:GUDRUN
Middle Name:A
Last Name:HARTIG
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10191
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96162-0191
Mailing Address - Country:US
Mailing Address - Phone:530-414-8444
Mailing Address - Fax:
Practice Address - Street 1:11457 NORTHWOODS BLVD APT B
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-6087
Practice Address - Country:US
Practice Address - Phone:530-414-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist