Provider Demographics
NPI:1649808981
Name:ENDERS, GARRETT (MAT, ATC)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:ENDERS
Suffix:
Gender:M
Credentials:MAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 COE ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-3154
Mailing Address - Country:US
Mailing Address - Phone:419-619-7238
Mailing Address - Fax:
Practice Address - Street 1:154 COE ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3154
Practice Address - Country:US
Practice Address - Phone:419-619-7238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer