Provider Demographics
NPI:1912287509
Name:GARCIA, GARRETT L (DPT)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:L
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 DERRY STREET
Mailing Address - Street 2:2ND FL
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:100 BRADFORD RD
Practice Address - Street 2:SUITE 131
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8486
Practice Address - Country:US
Practice Address - Phone:724-940-2323
Practice Address - Fax:724-940-2340
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021485225100000X
OHPT014148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist