Provider Demographics
NPI:1679313571
Name:GUILLOD, KIM
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:GUILLOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 WHISTLERS COVE LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-1267
Mailing Address - Country:US
Mailing Address - Phone:585-738-0453
Mailing Address - Fax:
Practice Address - Street 1:550 LATONA RD STE 421
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-2700
Practice Address - Country:US
Practice Address - Phone:585-698-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty