Provider Demographics
NPI:1508233461
Name:LABBERTON, GARRETT PETER IV (DPT)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:PETER
Last Name:LABBERTON
Suffix:IV
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1127 CLELIA CT
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-5616
Mailing Address - Country:US
Mailing Address - Phone:707-480-6559
Mailing Address - Fax:
Practice Address - Street 1:88 ROWLAND WAY
Practice Address - Street 2:#250
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5042
Practice Address - Country:US
Practice Address - Phone:415-898-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist