Provider Demographics
NPI:1518710748
Name:GARAGE TRAINING & REHAB GYM
Entity Type:Organization
Organization Name:GARAGE TRAINING & REHAB GYM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALTZ GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, CSCS, CMP, LMT
Authorized Official - Phone:971-719-3162
Mailing Address - Street 1:3607 E BUR OAK CT
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-7456
Mailing Address - Country:US
Mailing Address - Phone:503-481-5837
Mailing Address - Fax:
Practice Address - Street 1:3607 E BUR OAK CT
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7456
Practice Address - Country:US
Practice Address - Phone:971-719-3162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty