Provider Demographics
NPI:1588683932
Name:GARCIA, MARIE EUGENE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:EUGENE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3791 DOLAN WAY
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8358
Mailing Address - Country:US
Mailing Address - Phone:317-733-9094
Mailing Address - Fax:
Practice Address - Street 1:3791 DOLAN WAY
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-8358
Practice Address - Country:US
Practice Address - Phone:317-733-9094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005546A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist