Provider Demographics
NPI:1679909683
Name:GARRE, EMMA LEE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:LEE
Last Name:GARRE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625SEN ST B2
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-7008
Mailing Address - Country:US
Mailing Address - Phone:406-580-8434
Mailing Address - Fax:
Practice Address - Street 1:606 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3469
Practice Address - Country:US
Practice Address - Phone:406-580-8434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6010225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist