Provider Demographics
NPI:1275825085
Name:GARINGAN, ALLEN MARK
Entity Type:Individual
Prefix:
First Name:ALLEN MARK
Middle Name:
Last Name:GARINGAN
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 1:800 BLUE SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8201
Mailing Address - Country:US
Mailing Address - Phone:937-825-2647
Mailing Address - Fax:
Practice Address - Street 1:2 GRACEDALE AVE
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-8785
Practice Address - Country:US
Practice Address - Phone:610-746-1908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA020907225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist