Provider Demographics
NPI:1417329889
Name:GARCIA RODRIGUEZ, MARIA GRACIA (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:GRACIA
Last Name:GARCIA RODRIGUEZ
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 1:150 OSIGIAN BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8968
Mailing Address - Country:US
Mailing Address - Phone:478-333-3075
Mailing Address - Fax:478-333-3484
Practice Address - Street 1:150 OSIGIAN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8968
Practice Address - Country:US
Practice Address - Phone:478-333-3075
Practice Address - Fax:478-333-3484
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist