Provider Demographics
NPI:1831666957
Name:GARNATZ, ROSA (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:
Last Name:GARNATZ
Suffix:
Gender:F
Credentials:PT, DPT
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 1641
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-0179
Mailing Address - Country:US
Mailing Address - Phone:541-246-9867
Mailing Address - Fax:541-237-1204
Practice Address - Street 1:PO BOX 1641
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-0179
Practice Address - Country:US
Practice Address - Phone:541-246-9867
Practice Address - Fax:541-237-1204
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT62891225100000X
OR62891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist