Provider Demographics
NPI:1427774785
Name:TUTTLE, GLADYS K
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:K
Last Name:TUTTLE
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 1:3907 CARATOKE HWY
Mailing Address - Street 2:
Mailing Address - City:BARCO
Mailing Address - State:NC
Mailing Address - Zip Code:27917-9500
Mailing Address - Country:US
Mailing Address - Phone:252-457-0500
Mailing Address - Fax:
Practice Address - Street 1:3907 CARATOKE HWY
Practice Address - Street 2:
Practice Address - City:BARCO
Practice Address - State:NC
Practice Address - Zip Code:27917-9500
Practice Address - Country:US
Practice Address - Phone:252-457-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant