Provider Demographics
NPI:1376813253
Name:GARNER, ZEBULUN JAMES (LMT)
Entity Type:Individual
Prefix:
First Name:ZEBULUN
Middle Name:JAMES
Last Name:GARNER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4475 BEECH HAVEN TRL SE
Mailing Address - Street 2:APT 512
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6600
Mailing Address - Country:US
Mailing Address - Phone:404-453-0813
Mailing Address - Fax:
Practice Address - Street 1:1016 PIEDMONT AVE NE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3702
Practice Address - Country:US
Practice Address - Phone:404-453-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT007196225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist