Provider Demographics
NPI:1114142387
Name:GARNER, ROBERT D
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:D
Last Name:GARNER
Suffix:
Gender:M
Credentials:
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 985
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-0985
Mailing Address - Country:US
Mailing Address - Phone:406-433-5433
Mailing Address - Fax:406-488-8239
Practice Address - Street 1:116 S MERRILL AVE
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330-1635
Practice Address - Country:US
Practice Address - Phone:406-433-5433
Practice Address - Fax:406-488-8239
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U76162Medicare UPIN