Provider Demographics
NPI:1144585381
Name:GARCES, CONNIE MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:MARIE
Last Name:GARCES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:27 S PLEASANT
Practice Address - Street 2:STE 130
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29604-2577
Practice Address - Country:US
Practice Address - Phone:423-238-8930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27398225100000X
GAPT012328225100000X
SC8131225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist