Provider Demographics
NPI:1275871519
Name:SPOON, GARRICK BJORN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:GARRICK
Middle Name:BJORN
Last Name:SPOON
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:605 GLENWOOD DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1108
Mailing Address - Country:US
Mailing Address - Phone:423-495-2635
Mailing Address - Fax:423-495-2638
Practice Address - Street 1:605 GLENWOOD DR
Practice Address - Street 2:SUITE 303
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1108
Practice Address - Country:US
Practice Address - Phone:423-495-2635
Practice Address - Fax:423-495-2638
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical