Provider Demographics
NPI:1972917631
Name:GARNER, VIRGINIA ANN (MA, ATC)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:ANN
Last Name:GARNER
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:MS
Other - First Name:VIRGINIA
Other - Middle Name:ANN
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1016 W CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3145
Mailing Address - Country:US
Mailing Address - Phone:225-936-9750
Mailing Address - Fax:
Practice Address - Street 1:1016 W CYPRESS ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3145
Practice Address - Country:US
Practice Address - Phone:225-936-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer