Provider Demographics
NPI:1891274320
Name:GUIDO, WENDY (DPT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:GUIDO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3984 BOSAL ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-8887
Mailing Address - Country:US
Mailing Address - Phone:603-505-0745
Mailing Address - Fax:
Practice Address - Street 1:ROOT PEDIATRICS, 612 W GRIFFIN DR. UNIT A, BOZEMAN, MT
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-306-0128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10826991-2401225100000X
WYPT-18092251N0400X
IDPT-55592251P0200X
MTPTP-PT-LIC-300202251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics