Provider Demographics
NPI:1992865539
Name:GUETTLER, RICHARD L (RPH, CDM, MTM)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:GUETTLER
Suffix:
Gender:M
Credentials:RPH, CDM, MTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 ALGER ST
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01220-9714
Mailing Address - Country:US
Mailing Address - Phone:413-743-5616
Mailing Address - Fax:
Practice Address - Street 1:21 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01220-1315
Practice Address - Country:US
Practice Address - Phone:413-743-4659
Practice Address - Fax:413-743-2608
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist