Provider Demographics
NPI:1356396642
Name:GHEEN, GARRET A (PT)
Entity type:Individual
Prefix:
First Name:GARRET
Middle Name:A
Last Name:GHEEN
Suffix:
Gender:M
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:PO BOX 493396
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-3396
Mailing Address - Country:US
Mailing Address - Phone:530-221-9952
Mailing Address - Fax:530-221-9954
Practice Address - Street 1:2835 CHILDRESS DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3563
Practice Address - Country:US
Practice Address - Phone:530-378-0998
Practice Address - Fax:530-378-2072
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist