Provider Demographics
NPI:1669841680
Name:WOERMAN, GARRET (DPT)
Entity Type:Individual
Prefix:
First Name:GARRET
Middle Name:
Last Name:WOERMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3826 44TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49512-3919
Mailing Address - Country:US
Mailing Address - Phone:616-554-0918
Mailing Address - Fax:616-554-3079
Practice Address - Street 1:3826 44TH ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-3919
Practice Address - Country:US
Practice Address - Phone:616-554-0918
Practice Address - Fax:616-554-3079
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist