Provider Demographics
NPI:1356903074
Name:GARCIA, CHRISTIAN (ATC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 W GRANT ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2614
Mailing Address - Country:US
Mailing Address - Phone:414-628-7068
Mailing Address - Fax:
Practice Address - Street 1:1930 W GRANT ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-2614
Practice Address - Country:US
Practice Address - Phone:414-628-7068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer