Provider Demographics
NPI:1952447518
Name:GARRETT, ELLEN KATHERINE (ATC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:KATHERINE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4971 PECAN LN
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35005-1584
Mailing Address - Country:US
Mailing Address - Phone:205-601-2057
Mailing Address - Fax:
Practice Address - Street 1:700 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1866
Practice Address - Country:US
Practice Address - Phone:205-824-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer