Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 5150 | SC |
Y | 2251S0007X | Physical Therapist - Sports | 23470 | FL |
NPI | 1376627273 |
---|---|
Provider Name | Christy Garrison |
First Address | Tampa, FL 33612-4742 |
Second Address | Tampa, FL 33613-4706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 07/08/2007 |