Provider Demographics
NPI:1750909354
Name:GARVER, KEVIN (PT)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:GARVER
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41125 N DAISY MOUNTAIN DR STE 121
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4964
Mailing Address - Country:US
Mailing Address - Phone:480-265-2132
Mailing Address - Fax:
Practice Address - Street 1:16950 N 51ST AVE STE 3
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1323
Practice Address - Country:US
Practice Address - Phone:623-219-4242
Practice Address - Fax:623-219-4244
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist